Anatomical Joint Form Variation in Sacroiliac Joint Disease: Current Concepts and New Perspectives

Ziegeler, Katharina; Hermann, Kay-Geert A.; Diekhoff, Torsten

doi:10.1007/s11926-021-01033-7

Cited by 10 publications

(10 citation statements)

References 32 publications

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“…Currently, mechanical stress is also considered a trigger factor for chronic inflammatory arthropathies, which, in addition to biomechanical influence, can provoke an immune response. 16,18 In an analysis of the influence of atypical forms on the appearance of inflammatory or structural changes, we found an association This study has several limitations, including the monocentric setting and the retrospective design. The assessment of SIJ changes in MRE was limited compared to the evaluation of joint changes revealed in a dedicated MRI sacroiliac joint protocol due to a lack of inclined projections and a large FOV with lower spatial resolution.…”

Section: Ta B L Ementioning

confidence: 76%

“…The influence of mechanical stress on the appearance of subchondral joint changes has been increasingly discussed. [16][17][18][19][20][21] Several experimental and clinical studies also showed the role of mechanical stress even in developing inflammatory joint diseases. [19][20][21] For instance, Thorarensen et al and Zeng et al demonstrated that physical trauma or prolonged repetitive work, which led to mechanical stress, should be considered a risk factor for inflammatory joint disease in psoriatic (OR: 1.32, 95% CI: 1.13-1.54) and rheumatoid (OR: 1.8, 95% CI: 1.6-2.0) arthritis.…”

Section: Introductionmentioning

confidence: 99%

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Association between sacroiliac joint forms and subchondral changes in patients with Crohn's disease

Melekh,

Barajas Ordonez,

Melekh

et al. 2024

Int J of Rheum Dis

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AimTo assess the relationship between anatomical variants of sacroiliac joint (SIJ) and subchondral changes detected in magnetic resonance enterography (MRE) in patients with Crohn's disease (CD).MethodsThis was a retrospective study of 60 CD patients, who were divided into two groups: with (n = 16) and without SIJ (n = 44) involvement, depending on the presence of inflammatory (bone marrow edema) and structural changes (sclerosis and erosions) in MRE. Anatomical variants of SIJ were assessed in CT of the abdomen and/or pelvis, distinguishing typical form with convex iliac surface and atypical forms. Univariate and multivariate analyses were performed to reveal an association between joint changes and forms.ResultsOur study included 60 patients (38 males; mean age 38.72 years ± 13.33). Patients with SIJ changes were older (p = .044). No significant differences in CD localization and behavior were found. The most common SIJ lesions were structural changes (in 75% of patients); the main atypical form was the iliosacral complex. The univariate and multivariate analyses showed a significant association of atypical forms with total subchondral changes (odds ratio [OR]: 3.429, 95% confidence interval [CI] 1.043–11.268; p = .042; OR: 5.066, 95% CI: 1.273–20.167; p = .021, respectively), and with structural changes (OR: 4.185, 95% CI: 1.155–15.160; p = .029; OR: 5.986, 95% CI: 1.293–27.700; p = .022, respectively).ConclusionAtypical forms of SIJ are a risk factor for the occurrence of structural joint changes in CD patients. An association between bone marrow edema and atypical forms was not found.

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Section: Ta B L Ementioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Association between sacroiliac joint forms and subchondral changes in patients with Crohn's disease

Melekh,

Barajas Ordonez,

Melekh

et al. 2024

Int J of Rheum Dis

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“…Darüber hinaus existieren eine Reihe beschriebener Varianten der anatomischen Form des Sakroiliakalgelenks [13]. Am häufigsten werden die folgenden Varianten beschrieben [14]: das akzessorische Gelenk, das eine zusätzliche Gelenkfacette beschreibt, die sich dorsal des eigentlichen Gelenks im Spatium retroartikulare befindet; der ilio sa krale Komplex, auch als intraartikuläre Formvarian-te bezeichnet, der eine Unebenheit oder größere Einkerbung der Gelenkfläche beschreibt; das sichelförmige Ilium, bei der sich die morphologische Beziehung von Ilium und Sakrum umdreht, hin zu einem konvexen Sakrum gegenüber einem konkaven Ilium.…”

Section: Anatomische Geschlechtsunterschiedeunclassified

Geschlechtsspezifische Aspekte in der Bildgebung der axialen Spondyloarthritis

Ziegeler,

Poddubnyy

2024

Arthritis und Rheuma

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ZUSAMMENFASSUNGDie Bildgebung der Sakroiliakalgelenke spielt in der Diagnostik der axialen Spondyloarthritis eine zentrale Rolle. In der Interpretation der Bildgebung gibt es jedoch wichtige, geschlechtsspezifische Unterschiede zu beachten. So haben Frauen aufgrund anatomischer Gegebenheiten ein höheres Risiko, mechanisch-degenerative Erkrankungen der Sakroiliakalgelenke zu erleiden, die zuweilen schwer von einer Sakroiliitis zu unterscheiden sind. Bedeutend sind hier eine höhere Mobilität des Gelenkkomplexes sowie eine insgesamt kleinere Gelenkoberfläche und höhere Druckbelastungen im Gehen und Stehen; dies betrifft insbesondere Frauen in oder nach einer Schwangerschaft. Zudem existieren Geschlechtsunterschiede im radiologischen Erscheinungsbild der axialen Spondyloarthritis, insbesondere in der MRT. So finden sich bei Männern häufiger Ankylosen und postentzündliche Fettmetaplasie und bei Frauen häufiger gelenkbezogene Sklerosen. Insgesamt ist die diagnostische Genauigkeit der MRT der Sakroiliakalgelenke bei Frauen niedriger als bei Männern und sollte mit Vorsicht und unter Berücksichtigung der anatomischen Unterschiede interpretiert werden.

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“… 8 These anatomical distinctions in joint form have been found to be associated with an increased risk of SIJ pain and dysfunction in females. 25 Ziegeler et al 26 reported that, in a cohort of over 800 patients without documented SIJ disease, atypical joint forms were over four times more likely to occur among females, with an almost five times greater risk of radiographic evidence of dorsal osteophytes formation compared to males.…”

Section: Biomechanical and Clinical Correlatesmentioning

confidence: 99%

Minimally Invasive Inferior Intra-Articular Sacroiliac Joint Fusion: Successful Application of Osseous Stabilization Using Allograft Bone

Lynch¹,

Tubic²,

Foster³

et al. 2022

ORR

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Minimally invasive sacroiliac joint (SIJ) fusion is the preferred surgical method for managing patients with recalcitrant, chronically severe SIJ pain and dysfunction refractory to conservative medical measures. The primary surgical objective of all minimally invasive SIJ fusion procedures is to provide immediate stabilization within the joint space to support osseous consolidation and the development of a mechanically solid arthrodesis. The intra-articular surgical approach to the SIJ with allograft bone placement utilizes a trajectory and easily identifiable landmarks that allow the surgeon to control the risk of violating important neuro-vascular structures. The intra-articular approach can employ a superior or inferior operative trajectory, with the former restricted to allograft placement in the ligamentous portion of the SIJ. The inferior approach utilizes decortication to surgically create a channel originating in the purely articular portion of the joint space allowing for truly intra-articular implant placement within the osseous confines of the ilium and sacrum. Positioning the implant along the natural joint line and securing it within the underlying sub-chondral bone, mortise and tenon fashion provides stabilization and large surface area contact at the bone implant interface. The inferior, intra-articular approach also places the implant perpendicular to the S1 endplate, near the sacral axis of rotation, which addresses the most significant biomechanical forces across the joint. Short-term, post-surgical observational data from a 57 patient multi-center registry using the inferior, intra-articular approach show uniform and statistically significant improvement in all clinical outcomes (p < 0.001 for all comparisons), including an average 3-point improvement in back pain severity from 6.8 preoperatively to 3.8 at 6 months. Further clinical evaluation with longer-term follow-up of the inferior, intra-articular SIJ fusion procedure is encouraged.

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Anatomical Joint Form Variation in Sacroiliac Joint Disease: Current Concepts and New Perspectives

Cited by 10 publications

References 32 publications

Association between sacroiliac joint forms and subchondral changes in patients with Crohn's disease

Association between sacroiliac joint forms and subchondral changes in patients with Crohn's disease

Geschlechtsspezifische Aspekte in der Bildgebung der axialen Spondyloarthritis

Minimally Invasive Inferior Intra-Articular Sacroiliac Joint Fusion: Successful Application of Osseous Stabilization Using Allograft Bone

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