Radiological Insights into Sacroiliitis: A Narrative Review

Al-Mnayyis, Asma’a; Obeidat, Shrouq; Badr, Ammar; Jouryyeh, Basil; Azzam, Saif; Al Bibi, Hayat; Al-Gwairy, Yara; Al Sharie, Sarah; Varrassi, Giustino

doi:10.3390/clinpract14010009

Clinics and Practice

2024

DOI: 10.3390/clinpract14010009

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Radiological Insights into Sacroiliitis: A Narrative Review

Asma’a Al-Mnayyis,

Shrouq Obeidat,

Ammar Badr

et al.

Abstract: Sacroiliitis is the inflammation of the sacroiliac joint, the largest axial joint in the human body, contributing to 25% of lower back pain cases. It can be detected using various imaging techniques like radiography, MRI, and CT scans. Treatments range from conservative methods to invasive procedures. Recent advancements in artificial intelligence offer precise detection of this condition through imaging. Treatment options range from physical therapy and medications to invasive methods like joint injections an… Show more

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2024

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Cited by 3 publications

References 85 publications

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Sacroiliitis in familial Mediterranean fever: A rare joint involvement of the disease

Özçelik,

Çelikel,

Tekin

et al. 2024

J Paediatrics Child Health

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AimFamilial Mediterranean fever (FMF) is a monogenic autoinflammatory disease characterised by recurrent episodes of fever and polyserositis. Sacroiliac joint involvement is rare in FMF patients. The purpose of this study was to evaluate the demographic, clinical, laboratory and imaging findings of patients with FMF who developed sacroiliitis.MethodsThe files of paediatric patients aged 0–18 years who were followed up with a diagnosis of FMF were retrospectively reviewed. FMF patients with evidence of sacroiliitis on magnetic resonance imaging (MRI) were included in the study.ResultsAmong 1062 FMF patients, 22 (12 males; median age 8.5) (2.1%) of them were found to have sacroiliitis. FMF was diagnosed before sacroiliitis in nine (40.9%) patients and after in 13 (59.1%) patients. The most common symptom in patients with sacroiliitis was low back pain (n = 21, 95.5%). In MEFV gene analysis, M694V was found in 16 (72.7%) patients and was the most common mutation. MRI showed evidence of sacroiliitis in all patients. All patients were using colchicine. Patients with FMF‐associated sacroiliitis, remission was achieved with non‐steroidal anti‐inflammatory drugs in 12 (54.5%), conventional disease‐modifying antirheumatic drugs in six (27.3%) and tumour necrosis factor inhibitor treatment in four (31.8%). Four (31.8%) patients experienced sacroiliitis when colchicine incompatible and four (31.8%) patients experienced sacroiliitis while using biologic agents for colchicine‐resistant FMF.ConclusionsFMF‐associated sacroiliitis should be considered especially in patients with M694V mutation if they have symptoms such as low back pain. Colchicine‐resistant FMF patients should be evaluated for sacroiliitis symptoms at each visit.

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Sacroiliitis in familial Mediterranean fever: A rare joint involvement of the disease

Özçelik,

Çelikel,

Tekin

et al. 2024

J Paediatrics Child Health

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Imaging of Sacroiliac Pain: The Current State-of-the-Art

Carotti,

Ceccarelli,

Poliseno

et al. 2024

JPM

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Pain in the sacroiliac (SI) region is a common clinical manifestation, often caused by diseases involving the SI joints. This is typically due to inflammation or degenerative changes, while infections or cancer are less frequent causes. The SI joint is challenging to image accurately because of its distinct anatomical characteristics. For an accurate diagnosis, conventional radiography often needs to be supplemented with more precise methods such as magnetic resonance imaging (MRI) or computed tomography (CT). Sacroiliitis, a common presenting feature of axial spondyloarthritis (axial SpA), manifests as bone marrow edema, erosions, sclerosis, and joint space narrowing. Septic sacroiliitis and repetitive stress injuries in sports can also cause changes resembling inflammatory sacroiliitis. Other conditions, such as osteitis condensans ilii (OCI), can mimic the radiologic characteristics of sacroiliitis. Inflammatory lesions are diagnosed by concurrent erosions, hyperostosis, and ankylosis. Ligament ossifications or mechanical stress can also result in arthritic disorders. Determining the exact diagnosis can be aided by the distribution of the lesions. Inflammatory lesions can affect any part of the articulation, including the inferior and posterior portions. Mechanical lesions, such as those seen in OCI, often occur in the anterior middle region of the joint. In cases of idiopathic skeletal hyperostosis, ligament ossification is found at the joint borders. This pictorial essay describes common SI joint problems, illustrated with multimodal imaging data. We, also, discuss strategies for selecting the best imaging modalities, along with imaging pitfalls, key points, and approaches for treating patients with suspected inflammatory back pain.

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Comparison Of Three Methods for Calculation of Sacroiliac Joint Index in Different Age Groups in Bone Scintigraphy

Salmanoğlu

2024

Abant Med J

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Objective: The aim of this study is to evaluate three techniques for calculating the sacroiliac joint (SIJ) index by bone scintigraphy in patients. Materials and Methods: Patients (n:160) who did not exhibit abnormalities on bone scan were analyzed and were divided into 4 groups; 3-20 years, 21-40 years, 41-60 years, 61-86 years, respectively. Irregular and rectangular region of interest (ROI) were used for first and second methods, respectively. Horizontal rectangular ROI was selected for the last technique. The SIJ index was calculated by the following formula: SIJ count/sacrum count. Results: There was no difference between the averages of all three methods according to right and left SIJ index (p>0.05). The averages of all SIJ values differed for three methods (p

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Radiological Insights into Sacroiliitis: A Narrative Review

Cited by 3 publications

References 85 publications

Sacroiliitis in familial Mediterranean fever: A rare joint involvement of the disease

Sacroiliitis in familial Mediterranean fever: A rare joint involvement of the disease

Imaging of Sacroiliac Pain: The Current State-of-the-Art

Comparison Of Three Methods for Calculation of Sacroiliac Joint Index in Different Age Groups in Bone Scintigraphy

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