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. 2013 Dec 24;66(1):40–46. doi: 10.1002/acr.22201

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© 2014 The Authors. Arthritis Care & Research is published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Sagittal contrast-enhanced T1-weighted fat-saturated images of the lumbar spine in 4 different patients demonstrate the grades of apophyseal synovitis. A, Normal apophyseal joint. B, Abnormal enhancement (arrow) is confined within the apophyseal joint capsule indicating a grade 1 synovitis, clearly showing inflammation as compared to the normal apophyseal joint (A). C, Grade 2 synovitis with intraarticular synovial enhancement and periarticular high signal (arrow). D, Marked synovial enhancement and bone edema of the inferior articular process (arrow), indicating a grade 3 synovitis.