Elevated sacroiliac joint uptake ratios in systemic lupus erythematosus

Area of Science:

• Rheumatology
• Nuclear Medicine
• Radiology

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
• Sacroiliac joint involvement can occur in SLE patients.
• The diagnostic utility of sacroiliac joint imaging in active SLE requires further investigation.

Purpose of the Study:

• To evaluate sacroiliac joint radiographs and radionuclide uptake ratios in patients with active systemic lupus erythematosus.
• To determine if sacroiliac joint abnormalities correlate with disease activity or clinical symptoms.

Main Methods:

• 14 patients with active SLE underwent sacroiliac joint radiography and radionuclide scintigraphy.
• Quantitative sacroiliac joint uptake ratios were analyzed.
• Radiographic findings of sclerosis and erosions were assessed.

Main Results:

• Elevated sacroiliac joint uptake ratios were observed in 9 out of 14 patients during active SLE.
• Uptake ratios normalized in patients whose disease became quiescent.
• Two patients with persistently elevated ratios showed radiographic evidence of sacroiliac joint damage.
• No association was found between sacroiliac joint abnormalities and low back pain or HLA-B27 positivity.

Conclusions:

• Elevated quantitative sacroiliac joint uptake ratios can be a manifestation of active systemic lupus erythematosus.
• Sacroiliac joint scintigraphy may serve as a marker for disease activity in SLE.
• Radiographic changes in the sacroiliac joints can occur in severe, active SLE.