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. 2018;56(5):289-293.
doi: 10.5114/reum.2018.79499. Epub 2018 Oct 31.

All that glitters is not gold: sacroiliitis

Alfredo Tarantino  1 , Justyna Paulina Jablonska  1 , Paola D'Aprile  1
Affiliations

All that glitters is not gold: sacroiliitis

Alfredo Tarantino et al. Reumatologia. 2018.

Abstract

Objectives: The aim of this study was to determine the prevalence of "rheumatic" and "non-rheumatic" changes of the sacro-iliac joints (SIJ).

Material and methods: We performed MRI in 210 patients with suspected inflammatory low back pain. We sorted and analysed the characteristics of sacroiliac bone lesions in "rheumatic" and "non-rheumatic" patients and assessed the diagnostic values of their extent and location. SIJ lesions were classified on the basis of their location into two categories: unilateral and bilateral. Their extent was then measured and assigned to one of two groups: <1 cm or ≥ 1 cm.

Results: In 45 cases (21%), the MRI findings matched the clinical diagnosis of "rheumatic" sacroiliitis. Interestingly, in 99 cases (47%) the SIJ changes were classified as "non-rheumatic". L5-S1 degenerative changes, scoliosis and pelvic asymmetry were most frequently encountered as concomitant phenomena in our study.

Conclusions: MRI of the sacroiliac joints in patients suspected of inflammatory low back pain demonstrated more often "non-rheumatic" changes.

Keywords: magnetic resonance imaging; rheumatic diseases; sacroiliitis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Sacro-iliac joints MRI. Axial (A) and coronal (B) TSE T2W images with fat saturation. Bilateral subchondral bone oedema ≥ 1 cm (arrows). “Rheumatic” sacroiliitis (with inflammatory pathogenesis).
Fig. 2
Fig. 2
Sacro-iliac joints MRI. Axial (A), coronal (B) and sagittal (C) TSE T2W images with fat saturation. Unilateral subchondral bone oedema < 1 cm (arrow). Associated anterolisthesis of L4 over L5. “Non-rheumatic” sacroiliitis (with degenerative-mechanical pathogenesis).
See this image and copyright information in PMC

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