Sacroiliac joint morphologic changes from infancy to adulthood

Abstract

Background context: Report of sacroiliac morphology changes during growth is limited in the literature and the interest of such morphology and its consequence for surgery is increasing.Purpose: Aims of this work are 1) to anatomically define the sacroiliac joint (SIJ), 2) to assess the influence of growth on the sacroiliac morphology and the pelvic parameters.Study design: Forty-nine young subjects from 6 months to 18 years old (y/o) and 20 adults aged from 18 to 50 y/o were selected from our institutional patient database.Methods: They underwent a CT examination on a 128-MDCT (GE Healthcare Optima CT660). Transverse CT image datasets were reconstructed, anonymized and segmented with ITK-SNAP. Landmarks and surfaces were selected and a SIJ orientation analysis was performed using costumed Python scripts.Results: The subjects were divided into four groups: infants (1.9±1 y/o), children (6.9±1.7 y/o), adolescents (13.7±1.8 y/o) and adults (27.3±5.6 y/o). Differences between SIJ orientation were found significant between young subject groups for synovial sacrum SIJ orientation (p<0.001) and iliac total SIJ orientation (p=0.036).Both orientations of younger subjects were found significantly different from the adult group (p<0.035). SIJ synovial sacrum and iliac total orientations correlated significantly with age (p<0.03). All orientations correlated with pelvic incidence (PI) (p<0.04) except for synovial sacrum SIJ orientation (p=0.2). No gender or symmetrical differences were found significant in any group. Conclusion:Morphological definition of the SIJ confirmed the independency of the gender during growth. Such results will be beneficial for the analysis and management of vertebral pathology.

Developmental sacral morphology: MR study from infancy to skeletal maturity

“…An additional notable finding was the increase in the sacral table angle and sacral angle until age 10. This growth pattern may be a factor in the changes of pelvic incidence during childhood and adolescence [14]. From these MR images, we were not able to measure the sacral acetabular distance (i.e., pelvic thickness), another factor in the development of pelvic incidence.…”

Influence of size and shape of the auricular surfaces on subchondral bone density distribution in the sacroiliac joint

“…The area of the auricular surface has commonly been quoted on the values reported by Brooke ( 1923 ): approximately, 1.5 cm 2 at birth, 7 cm 2 during puberty and up to 17.5 cm 2 as an adult (Bellamy et al, 1983 ; Cole et al, 1996 ; Slipman et al, 2001 ; Zlomislic & Garfin, 2019 ). Further studies have specifically measured the auricular surface size in adults between the sexes, sides and bones with results ranging from 10.0 to 12.8 cm 2 (Coudert et al, 2019 ; Nishi et al, 2020 ; Rana et al, 2015 ; Valojerdy & Hogg, 1989 ). No significant difference was found between the sacral and iliac sides nor between left and right sides, but there is a significant difference between sexes (Nishi et al, 2020 ; Valojerdy & Hogg, 1989 ).…”

Similarities and Differences Between Juvenile and Adult Spondyloarthropathies

“…Similarly, normal SIJ development is dependent torsion between the ilia and the sacrum (128, 242). Changes in SIJ orientation are seen with age and significant differences are found between adults and children and adolescents (243). In addition, distinct pelvic morphology develops in males and females after puberty with larger SIJ surface area in males thought to be related to higher biomechanical loading and larger ligamentous attachments (244).…”