Spectrum of central nervous system involvement in rheumatic diseases: pictorial essay

Abstract The rheumatic diseases, which include systemic lupus erythematosus, rheumatoid arthritis, Behçet's disease, scleroderma, and ankylosing spondylitis, are characterized by involvement of connective tissue, with multiple manifestations. In those diseases, there can be involvement of the peripheral or central nervous system, and that involvement can be primary, presenting as a major feature of the clinical presentation, or secondary, as an effect of the drugs used in order to control a given disease or its complications. Knowledge of the wide variety of imaging findings is crucial to the diagnosis of a rheumatic disease, especially in the early stages, enabling effective treatment and minimizing disability. This pictorial essay, presenting cases from the records of two tertiary teaching hospitals, encompasses cases of patients diagnosed with rheumatic disease and illustrates the neuroradiological findings on magnetic resonance imaging and computed tomography, in order to emphasize the importance of these methods for properly diagnosing rheumatic diseases.

摘要 风湿性疾病（rheumatic diseases）涵盖系统性红斑狼疮、类风湿关节炎、白塞病、硬皮病及强直性脊柱炎，以结缔组织受累为特征，临床表现多样。此类疾病可累及外周或中枢神经系统，受累情况可分为原发性——作为临床表现的主要特征出现，或继发性——由用于控制疾病本身或其并发症的药物所诱发。掌握丰富多样的影像学表现，对风湿性疾病的诊断至关重要，尤其在疾病早期阶段，可助力开展有效治疗并最大限度降低致残率。本影像图集收录了两家三级教学医院的临床病例，囊括确诊风湿性疾病的患者案例，并展示其磁共振成像（magnetic resonance imaging）与计算机断层扫描（computed tomography）的神经影像学表现，以此凸显此类影像学检查方法对风湿性疾病精准诊断的重要价值。