Magnetic resonance imaging of septic sacroiliitis

Five cases of septic sacroiliitis diagnosed by magnetic resonance imaging (MRI) are presented. Imaging was performed between 2 and 14 days after onset of symptoms and consisted of varying combinations of coronal short tau inversion recovery (STIR), axial T2-weighted spin echo (SE), and coronal and axial pre- and postcontrast T1-weighted SE scans. Abnormalities included demonstration of sacroiliac joint effusions, bone oedema and adjacent inflammation as high signal on STIR and T2-weighted SE scans, and identification of abscesses in two cases as rim-enhancing lesions anterior to the joint on gadolinium-enhanced T1-weighted SE scans. The role of MRI and other forms of imaging in septic sacroiliitis is discussed.