Imaging of Sacroiliac Pain: The Current State-of-the-Art
Abstract
:1. Introduction
2. Inflammatory Sacroiliitis
3. Infective (Septic) Sacroiliitis
4. Postpartum Bone Marrow Edema at the Sacroiliac Joints
5. Osteoarthritis
6. Osteitis Condensans Ilii
7. Diffuse Idiopathic Skeletal Hyperostosis
8. Insufficiency (Stress) Fractures
9. Neoplasia or Metastasis
10. Pearls and Pitfalls of SI Joint Imaging
11. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Performance: sensitivity 77.0% and specificity 91.7% if at least four out of five parameters are present. Note that sensitivity and specificity refer to the presence of IBP, not to diagnosis. |
Overarching principles |
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MRI sacroiliac joint lesion definitions indicating signs of activity |
These observations are made on MRI sequences that are sensitive for the detection of disease activity such as T2-weighted (T2W) sequences with fat suppression (FS) that are sensitive for free water (e.g., short tau inversion recovery (STIR)), or T1W sequences with fat suppression that are sensitive for contrast enhancement such as T1WFS post gadolinium (Gd). |
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MRI sacroiliac joint lesion definitions indicating signs of structural change |
These observations are made on MRI sequences that are sensitive to the detection of structural change. Most of the observations can only be seen clearly on sequences sensitive to fat signal, specifically T1W spin echo without fat suppression. |
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Chronic Back Pain (≥ 3 months) and Age at Onset < 45 Years | |||
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Sacroileitis on imaging ≥1 SpA feature | or | HLA-B27 positivity≥2 other SpA feature | |
SpA features | |||
Inflammatory back pain Peripheral arthritis Dactylitis Enthesitis (heel) Family history of SpA | Good response to NSAIDs Uveitis Psoriasis Crohn’s/Colitis HLA-B27 Elevated CRP |
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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Carotti, M.; Ceccarelli, L.; Poliseno, A.C.; Ribichini, F.; Bandinelli, F.; Scarano, E.; Farah, S.; Di Carlo, M.; Giovagnoni, A.; Salaffi, F. Imaging of Sacroiliac Pain: The Current State-of-the-Art. J. Pers. Med. 2024, 14, 873. https://doi.org/10.3390/jpm14080873
Carotti M, Ceccarelli L, Poliseno AC, Ribichini F, Bandinelli F, Scarano E, Farah S, Di Carlo M, Giovagnoni A, Salaffi F. Imaging of Sacroiliac Pain: The Current State-of-the-Art. Journal of Personalized Medicine. 2024; 14(8):873. https://doi.org/10.3390/jpm14080873
Chicago/Turabian StyleCarotti, Marina, Luca Ceccarelli, Anna Claudia Poliseno, Francesca Ribichini, Francesca Bandinelli, Enrico Scarano, Sonia Farah, Marco Di Carlo, Andrea Giovagnoni, and Fausto Salaffi. 2024. "Imaging of Sacroiliac Pain: The Current State-of-the-Art" Journal of Personalized Medicine 14, no. 8: 873. https://doi.org/10.3390/jpm14080873