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. 2020 Jul 22;7(6):551-556.
doi: 10.14744/nci.2020.48030. eCollection 2020.

Increased prevalence of pelvic venous congestion sign on sacroiliac MRI in women with clinically suspected sacroiliitis

Ahmet Peker  1 , Gozde Tokatli Camkerten  1 , Ali Balci  1 , Isil Basara Akin  1 , Canan Altay  1 , Gercek Can  2
Affiliations

Increased prevalence of pelvic venous congestion sign on sacroiliac MRI in women with clinically suspected sacroiliitis

Ahmet Peker et al. North Clin Istanb. .

Abstract

Objective: To compare the prevalence of pelvic venous congestion (PVC) sign on sacroiliac and hip MRI in women of reproductive age as a possible cause of pain mimicking sacroiliitis.

Methods: This retrospective study included 727 MRI examinations (401 sacroiliac joint MRI and 326 hip joint MRI) that were performed between January 2010 and December 2017. Images were evaluated for the presence of sacroiliitis, presence of PVC sign and presence of other incidental findings of musculoskeletal and genitourinary disorders. After removing patients with other musculoskeletal and genitourinary disorders that may cause pain (n=188), remaining 539 (322 sacroiliac and 217 hip), MRI examinations were re-analyzed for the presence of PVC sign.

Results: Four hundred one patients with sacroiliac MRI examination had 120 (29.9%) PVC sign and 326 patients with hip MRI examinations had 54 (16.6%) PVC sign (p<0.001). After removing patients with other musculoskeletal and genitourinary disorders that may cause pain, 322 patients with sacroiliac MRI had 102 (31.7%) PVC sign and 217 patients with hip MRI examinations had 38 (17.5%) PVC sign (p<0.001). No significant difference was found between patients with acute sacroiliitis and patients without acute sacroiliitis concerning PVC prevalence (p>0.05). There were also no significant differences between other comparable incidental findings.

Conclusion: Significantly increased PVC prevalence in sacroiliac MRI exams may be attributable to PCS simulating clinical sacroiliitis.

Keywords: Pelvic congestion syndrome; pelvic venous congestion sign; sacroiliitis.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

FIGURE 1
FIGURE 1
(A, B) Sacroiliac MRI of a 38-year-old patient with back pain. Para-coronal STIR images show peri-articular high signal intensity on two consecutive slices suggesting active sacroiliitis according to the ASAS criteria.
FIGURE 2
FIGURE 2
Sacroiliac MRI of a 43-year-old female patient with back pain. Proton density para- axial image show bilaterally enlarged and tortuous veins of varying caliber, the largest measuring 8.5 mm on the right side.
FIGURE 3
FIGURE 3
Hip joint MRI of a 34-year-old patient with hip pain. Coronal FS T2-weighted image shows dilated right ovarian vein measuring 8.5 mm.
See this image and copyright information in PMC

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