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Sacroiliac arthrograms and post-arthrography computerized tomography.

Joseph D Fortin1, Ronald B Tolchin

  • 1Spine Technology and Rehabilitation, Clinical Professor, Indiana University School of Medicine, 7230 Engle Road, Suite 210, Fort Wayne, IN 46804, USA. fortin@pol.net

Pain Physician
|August 2, 2006
PubMed
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This study compared sacroiliac joint (SIJ) arthrography and post-arthrogram CT scans for diagnosing SIJ pathology. Both imaging techniques showed high agreement, with CT better visualizing anterior capsule findings and arthrography identifying more diverticula.

Area of Science:

  • Radiology
  • Orthopedics
  • Anatomy

Background:

  • Sacroiliac joint (SIJ) injections and arthrography are established procedures.
  • No prior studies have specifically compared the morphological characteristics of SIJ arthrograms with post-arthrogram CT scans.

Purpose of the Study:

  • To categorize and compare the morphological characteristics of SIJ arthrograms versus post-arthrogram CT scans.
  • To assess the correlation between imaging findings and provocation positive outcomes.

Main Methods:

  • Radiographic evaluation of 43 patients (mean age 33 years) for SIJ pathology.
  • Performed 74 SIJ injections using image-intensifier control and a posterior-inferior approach.
  • Classified and scored SIJ capsule findings (anterior, posterior, superior, inferior) using plain film arthrography followed by post-arthrogram CT.

Related Experiment Videos

Main Results:

  • Significant direct correlation between plain film and CT arthrography findings (Kendall's tau 0.63-0.99, p<0.01).
  • Significant correlation between positive provocation outcomes and contrast volume (Kendall's tau 0.25, p<0.01; ANOVA, p<0.03).
  • Post-arthrogram CT revealed more anterior capsule findings (p<0.04), while plain film arthrography identified more diverticula (p<0.01).

Conclusions:

  • Detailed radiographic analysis of the SIJ capsule is feasible with both plain film arthrography and post-arthrogram CT.
  • Excellent agreement exists between the two imaging techniques for SIJ pathology assessment.
  • Each modality offers specific regional benefits for evaluating the SIJ capsule.