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Magnetic resonance imaging of septic sacroiliitis
K Sandrasegaran1, A Saifuddin, A Coral
1Department of Radiology, St. James's University Hospital, Leeds, UK.
Abstract:
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.
Insights
Magnetic resonance imaging (MRI) effectively diagnoses septic sacroiliitis by revealing joint effusions, bone edema, and inflammation. This advanced imaging can identify abscesses, aiding in prompt treatment of this serious infection.
Area of Science:
- Radiology
- Infectious Diseases
- Orthopedics
Background:
- Septic sacroiliitis is a rare but serious infection affecting the sacroiliac joints.
- Early diagnosis is crucial for effective treatment and preventing complications.
Observation:
- This study presents five cases of septic sacroiliitis diagnosed using magnetic resonance imaging (MRI).
- Imaging protocols included various MRI sequences like STIR, T2-weighted SE, and contrast-enhanced T1-weighted SE scans.
- Symptoms onset ranged from 2 to 14 days prior to imaging.
Findings:
- MRI demonstrated sacroiliac joint effusions, bone edema, and adjacent inflammation as high signal intensity on STIR and T2-weighted images.
- Gadolinium-enhanced T1-weighted scans identified rim-enhancing lesions anterior to the joint, indicative of abscesses in two cases.
Implications:
- MRI is a valuable tool for diagnosing septic sacroiliitis, offering detailed visualization of inflammatory changes and abscesses.
- The findings highlight MRI's role in the early and accurate diagnosis of this condition.
- Further research can explore the comparative efficacy of different MRI sequences in septic sacroiliitis.