Frequency of sacroiliitis among patients with low back pain

Abstract

IntroductionSacroiliitis is one of the important symptoms in patients attending infectious diseases and rheumatology clinics. Some patients with sacroiliitis are asymptomatic, and some have unspecific symptoms. The aim of this study was to determine the frequency of sacroiliitis causes among patients attending Shahid Sadoughi’s infectious disease and rheumatology clinics.MethodsIn this study, we evaluated patients attending Shahid Sadoughi rheumatology and infectious diseases clinic in 2014. Patients who had positive findings in favor of sacroiliitis were evaluated by history, physical exam, laboratory tests, and imaging. The patients were divided into infectious, inflammatory non-infectious, and degenerative causes. The data were analyzed by IBM SPSS version 20 using the independent samples t-test, ANOVA, the chi-squared test, and the Fisher’s exact test.ResultsWe studied 136 patients. Among them 64 (47.1%) were male, and 72 (52.9%) were female. The mean age of the participants was 34.28 ± 10.36 years. Among the patients, 12 (8.8%) had infectious causes, 120 (88.2%) had inflammatory non-infectious causes, and four (2.9%) had degenerative causes.ConclusionBased on our results, inflammatory non-infectious causes are at the top of the list of sacroiliitis causes, but we should always consider infectious causes, including brucellosis.

Added value of coronal-T1W sequence to the lumbar MR imaging protocol for low back pain

“…Most of these problems cannot be detected using the conventional lumbar MRI examination protocol. In many clinics, a coronal STIR sequence has been added to the lumbar MRI protocol to detect sacroiliitis, which is one of the major causes of low back pain (14). The use of a coronal-T1W sequence instead of a coronal STIR sequence appears to be highly successful in the diagnosis of sacroiliitis.…”

Clinical impact of coronal-STIR sequence in a routine lumbar spine MR imaging protocol to investigate low back pain

“…The major extraspinal causes of LBP, affecting sacroiliac joints, coxofemoral joints or pelvic bones, are not routinely imaged by the conventional MR imaging protocol of the lumbar spine; furthermore, sacroiliitis, one of the most important causes of unresolved LBP, is better assessed on STIR images and detectable only on the coronal plane. [ 12 ] Of the 46 relevant extraspinal imaging findings (Category 1 and 2) detected in our study, 71% (33/46) were not included on sagittal plane and would not have been identified using a conventional MR acquisition protocol of the lumbar spine. The pathological extraspinal imaging findings detected in our study were renal in 30% (18/60) of cases and 3 of these were considered related to LBP (2 patients with bilateral hydronephrosis and 1 patient with ureteral lithiasis and unilateral hydronephrosis).…”

Incidence of Sacroiliitis among Patients Presenting with Chronic Low Back Pain to a Tertiary Care Spine Center

“…2 Inflammatory sacroiliitis, accounting for 88% of sacroiliac arthritis, is a pathognomonic feature of inflammatory SpA. 3 Inflammatory SpA presents with early morning back pain and pain at rest, which is relieved with activity along with MRI and/ or radiological features of inflammatory sacroiliitis. The typical bamboo spine appearance on radiographs and clinical features of a stiff, fused spine occurs in the later course of the disease.…”

“…7 Inflammatory etiology accounts for 88% of sacroiliitis and is often missed due to the absence of significant radiological findings in the early stages and difficulty in distinguishing it from pain arising due to intervertebral disc herniation and lumbar facet arthritis. 3 Aggarwal et al found a delay of 6.9 years in diagnosing AS due to incorrect diagnosis as nonspecific back pain (35.1%), rheumatoid arthritis (20.37%) degenerative disc disease (25.9%) and tuberculosis of spine (16.6%). The delay in diagnosis of this condition has also been significantly attributed to the lack of extra-articular symptoms or signs and the young age of the patient.…”