The SIJ should be classified anatomically as a symphysis with some characteristics of a synovial joint being confined to the distal cartilaginous portion at the iliac side. Coronal MR imaging does not allow assessment of normal anatomy, variants or abnormalities of the ventral and dorsal margins of the cartilaginous SIJ.
MR of the SIJs is reliable in its visualization of joint erosions in early SpA and allows differentiation between active and chronic sacroiliitis. We recommend the following sequences: semicoronal T1 and both semicoronal and semiaxial STIR. If these images are normal, the examination can be finished; otherwise additional semicoronal T1 FS before and after i.v. contrast has to be performed as well as semiaxial post-contrast T1 FS.
From 1970 to 1978, 29 patients had a unilateral operation for bilateral recurrent dislocation of the patella. We examined 21 of them at a mean of 14 years postoperatively. Eighteen of these patients had evidence of generalised joint laxity. Six of the operated knees and four of the unoperated knees still had recurrent dislocations. The operated knees were clinically worse, with a significantly higher incidence of osteoarthritis. We concluded that the operations used to treat recurrent dislocation of the patella may have had short-term benefits, but did not cure the patients in the long term.
• The location of vertebral endplate signal changes supports a mechanical aetiology. • Several sacroiliac joint findings were associated with female gender and pregnancy-related back pain. • Sacroiliac joint bone marrow oedema was frequent and age-associated, indicating a possible degenerative aetiology. • More knowledge of the clinical importance of sacroiliac joint MRI findings is needed.
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