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Imaging of sacroiliitis.

J Braun1, J Sieper, M Bollow

  • 1Department of Nephrology and Endocrinology, UK Benjamin Franklin, Free University, Berlin, Germany. jbraun@ukbf.fu-berlin.de

Clinical Rheumatology
|April 7, 2000
PubMed
Summary

Sacroiliitis, inflammation of the sacroiliac joints, is key in spondyloarthropathies. Advanced imaging like MRI is crucial for diagnosing sacroiliitis, especially when X-rays are inconclusive.

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Area of Science:

  • Rheumatology
  • Medical Imaging

Background:

  • Sacroiliitis, inflammation of sacroiliac joints, is a hallmark of spondyloarthropathies (SpA).
  • It frequently causes inflammatory back pain (IBP) and is a diagnostic criterion for SpA.
  • Sacroiliitis is nearly always present in ankylosing spondylitis (AS).

Purpose of the Study:

  • To highlight the diagnostic challenges of sacroiliitis, particularly in early stages.
  • To evaluate the utility of various imaging techniques for diagnosing sacroiliitis.
  • To emphasize the role of advanced imaging in SpA diagnosis.

Main Methods:

  • Review of diagnostic criteria and imaging modalities for sacroiliitis.
  • Comparison of conventional radiography, scintigraphy, computed tomography (CT), and magnetic resonance imaging (MRI).

Main Results:

  • Conventional radiographs can be normal in early or acute sacroiliitis.
  • Scintigraphy lacks specificity for sacroiliitis diagnosis.
  • CT effectively shows bony changes, while MRI excels at visualizing inflammation, edema, and potential spread to muscles.

Conclusions:

  • Accurate diagnosis of sacroiliitis can be challenging due to limitations of conventional radiography.
  • Advanced imaging techniques, especially MRI, are vital for detecting sacroiliitis and differentiating it from other conditions like septic sacroiliitis.

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