Nucleographic Studies of Axial Spondarthritides I. Quantitative Sacroiliac Scintigraphy in Early HLA‐B27‐Associated Sacroiliitis

Namey, Thomas C.; McIntyre, J L; Buse, Maria G.; LeRoy, E. Carwile

doi:10.1002/art.1780200504

Cited by 69 publications

(23 citation statements)

References 11 publications

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“…The difference is statistically significant (n= 18, t=3 * 14, P <O 005). It has been shown that in the short term anti-inflammatory therapy can induce a return towards normal in the sacroiliac scan of ankylosing spondylitics (Namey et al, 1977), and our results suggest that such improvement may persist for long periods. A similar phenomenon has been observed in acute Reiter's syndrome (Moll, 1976), it may simply be an illustration of the difficulty that may be experienced in distinguishing inflammatory from degenerative changes in this area (Resnick et al, 1977).…”

Section: Discussionsupporting

confidence: 68%

“…The technique is particularly applicable to the sacroiliac joints, where the uptake of radiotracer can be accurately quantitated in relation to the uptake by the central sacrum (Lentle et al, 1977a;Namey et al, 1977 tool for the early diagnosis of ankylosing spondylitis and similar conditions. To test this postulate we have followed up a number of patients with scintigraphic sacroiliitis and radiologically normal sacroiliac joints, and we report our findings in this paper.…”

mentioning

confidence: 99%

“…The technique is particularly applicable to the sacroiliac joints, where the uptake of radiotracer can be accurately quantitated in relation to the uptake by the central sacrum (Lentle et al, 1977a;Namey et al, 1977). The resultant sacroiliac joint to sacrum uptake ratios are clearly raised in a number of diseases associated with sacroiliitis (Russell et al, 1975;Russell et al, 1976a;Russell et al, 1976b;Lentle et al, 1977b;Barraclough et al, 1977;Russell et al, 1977;Davis et al, in press), and, while most of the patients studied had radiological changes in their sacroiliac joints, an appreciable number did not.…”

mentioning

confidence: 99%

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Sacroiliitis detected by bone scintiscanning: a clinical, radiological, and scintigraphic follow-up study.

Chalmers¹,

Lentle²,

Percy³

et al. 1979

Annals of the Rheumatic Diseases

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SUMMARY Twenty-four patients had abnormal sacroiliac joints detected by quantitative sacroiliac scintigraphy but no radiological evidence of sacroiliitis on original investigation. We studied them again after intervals of 12 to 36 months. Four patients developed radiological change. Two young, HLA B27-positive men had undoubted ankylosing spondylitis, and a young woman had possible ankylosing spondylitis. A middle-aged man had changes that could be attributed to post-traumatic osteoarthrosis. Of the remaining 20 cases 15 had symptoms and signs suggestive of inflammatory disease of the axial skeleton (and peripheral arthropathy in 5 cases). The sexes were affected equally (8 females, 7 males), and only 2 of the 15 were B27-positive. The response to anti-inflammatory medication was generally good to excellent, and scintiscans tended to improve. Of the remaining 5 patients, 3 had mechanical or traumatic problems, and in 2 there was no explanation for the abnormal sacroiliac scintiscan. We conclude that quantitative sacroiliac scintigraphy may detect ankylosing spondylitis prior to the development of radiological change and that it can identify an organic basis for backache in patients with a spondylitis-like syndrome. The clinical circumstances must be taken into account, as scintigraphic abnormalities are not diagnostic of any specific disease entity.Bone scanning with 99mtechnetium-labelled stannous pyrophosphate is a sensitive means of detecting disease of the axial skeleton (Lentle et al., 1976). The technique is particularly applicable to the sacroiliac joints, where the uptake of radiotracer can be accurately quantitated in relation to the uptake by the central sacrum (Lentle et al., 1977a;Namey et al., 1977 tool for the early diagnosis of ankylosing spondylitis and similar conditions. To test this postulate we have followed up a number of patients with scintigraphic sacroiliitis and radiologically normal sacroiliac joints, and we report our findings in this paper. Patients and methodsOur cases were selected from a series of 172 patients seen prior to 1976 who had abnormal sacroiliac joints on bone scanning. We excluded all those with radiological abnormalities and all who had a diagnosis of psoriatic spondylitis or Reiter's syndrome and were left with 37 names. From these we traced 27 patients who were willing to participate in the project. Three were found on review not to fulfil the criteria for inclusion: 2 had scintiscans that were probably normal for the patients' degree of skeletal immaturity, and 1 had radiological abnormalities evident on the original films.The final study population of 24

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Section: Discussionsupporting

confidence: 68%

mentioning

confidence: 99%

“…The technique is particularly applicable to the sacroiliac joints, where the uptake of radiotracer can be accurately quantitated in relation to the uptake by the central sacrum (Lentle et al, 1977a;Namey et al, 1977). The resultant sacroiliac joint to sacrum uptake ratios are clearly raised in a number of diseases associated with sacroiliitis (Russell et al, 1975;Russell et al, 1976a;Russell et al, 1976b;Lentle et al, 1977b;Barraclough et al, 1977;Russell et al, 1977;Davis et al, in press), and, while most of the patients studied had radiological changes in their sacroiliac joints, an appreciable number did not.…”

mentioning

confidence: 99%

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Sacroiliitis detected by bone scintiscanning: a clinical, radiological, and scintigraphic follow-up study.

Chalmers¹,

Lentle²,

Percy³

et al. 1979

Annals of the Rheumatic Diseases

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“…Early reports in the 1970s about the diagnostic role of scintigraphy to detect sacroiliitis were promising;21 – 24 however, subsequent studies have suggested that clear separation of active AS from controls is difficult 25 – 32. Thus, data about the diagnostic value of scintigraphy to detect acute inflammatory changes in the sacroiliac joint (SIJ) for the diagnosis of non-radiographic axial spondyloarthritis (early forms of axial spondyloarthritis) and radiographic axial spondyloarthritis (AS) are conflicting.…”

mentioning

confidence: 99%

The diagnostic value of scintigraphy in assessing sacroiliitis in ankylosing spondylitis: a systematic literature research

Song

Carrasco-Fernández

Rudwaleit

et al. 2008

Annals of the Rheumatic Diseases

119

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“…The abnormally increased radionuclide uptake is felt to reflect active inflammation in the SI joints, thus allowing for early differentiation of patients with sacroiliitis from those with other causes of lower back pain. Significant focally increased activity over the SI joints in the blood pool phase is felt to be secondary to soft tissue inflammation, provided that activity from the ureter, iliac vessels, and other surrounding structures could be excluded [17][18][19]. There has been much criticism of bone scintigraphy's role in the diagnosis of sacroiliitis.…”

Section: Bone Scintigraphymentioning

confidence: 99%

Imaging of the seronegative spondyloarthropathies

Luong

Salonen

2000

Curr Rheumatol Rep

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The group of seronegative spondyloarthropathies consists of ankylosing spondylitis, psoriatic arthritis, Reiter's disease, enteropathic spondylitis, and a fifth entity known as undifferentiated spondyloarthropathy. All of these diseases share common clinical and radiographic features with characteristic involvement of the sacroiliac joints, spine, and to various degrees, the peripheral joints. Although plain radiographs are the first line of imaging investigation, they are often insensitive for demonstrating the early changes of sacroiliitis, an important feature for establishing the early diagnosis of seronegative spondyloarthropathy. Other imaging modalities, including conventional tomography, bone scintigraphy, and computed tomography, have improved visualization of inflammatory changes at the sacroiliac joints. This article will review these modalities and emphasize the role of magnetic resonance imaging. By directly imaging changes in the synovium, articular cartilage, and subchondral bone, findings on magnetic resonance imaging are the most sensitive and specific for sacroiliitis and other changes in the axial skeleton. Its role and that of ultrasound in the assessment of the peripheral joints will also be highlighted.

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Nucleographic Studies of Axial Spondarthritides I. Quantitative Sacroiliac Scintigraphy in Early HLA‐B27‐Associated Sacroiliitis

Cited by 69 publications

References 11 publications

Sacroiliitis detected by bone scintiscanning: a clinical, radiological, and scintigraphic follow-up study.

Sacroiliitis detected by bone scintiscanning: a clinical, radiological, and scintigraphic follow-up study.

The diagnostic value of scintigraphy in assessing sacroiliitis in ankylosing spondylitis: a systematic literature research

Imaging of the seronegative spondyloarthropathies

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