Sacroiliitis: current imaging modalities and future directions: a narrative review

Area of Science:

• Radiology
• Rheumatology
• Orthopedics

Background:

• Sacroiliitis, inflammation of the sacroiliac joints (SIJs), presents diagnostic challenges due to diverse patient symptoms and non-specific pain.
• Distinguishing sacroiliitis from other causes of lower back and buttock pain requires accurate diagnostic modalities.

Purpose of the Study:

• To provide a comprehensive overview of imaging modalities used in diagnosing sacroiliitis.
• To discuss the clinical utility, limitations, and emerging techniques for sacroiliitis imaging.

Main Methods:

• This narrative review synthesizes information on various imaging techniques for sacroiliitis.
• Key modalities discussed include radiography, MRI, CT, SPECT/CT, and PET/CT.
• Emerging techniques like digital tomosynthesis (DT), VIBE MRI, and DECT are also examined.

Main Results:

• Traditional imaging like radiography and MRI are commonly used but have limitations.
• Advanced techniques such as CT, SPECT/CT, and PET/CT offer alternative diagnostic pathways.
• Novel imaging acquisition and analysis methods are improving diagnostic accuracy.

Conclusions:

• Accurate diagnosis of sacroiliitis relies on a combination of clinical assessment and appropriate imaging.
• Various imaging modalities, both established and emerging, play crucial roles in evaluating sacroiliitis.
• Continued advancements in imaging technology promise enhanced diagnostic capabilities for sacroiliitis.