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Imaging

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The following imaging modalities may be used:

  • plain abdominal radiograph should be carried out - there may be signs of sacro-ileitis and skip lesions, although the latter are hard to see on the plain film.
  • small bowel contrast study there may be strictures, fistulae and ulceration - rose thorn ulcers - and cobblestone mucosal surfaces. Kantor's string sign - luminal narrowing of the ileum - may be present, with clinical features of partial obstruction.
  • large bowel enema may demonstrate discontinuous skip lesions with normal bowel between, a ragged luminal outline due to ulceration, and loss of haustration. Other features may include rose thorn ulcers and pseudo-diverticulae caused by fibrotic stricturing.
  • CT scanning may show an inflammatory mass or an abscess.
  • labelled white cell scan may also be helpful in the demonstration of the extent of inflammation if barium radiology is equivocal.
  • ultrasound is useful in detection of abscesses.
  • radionucleotide scanning may be useful in detection of areas of disease activity.
  • MRI is the procedure of choice for the investigation of complex perianal disease.
  • in children the bone age may be two or more years less than the chronological age.

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