imaging

Last reviewed 01/2018

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.