The investigation of sacroiliitis with different imaging techniques in spondyloarthropathies

Abstract

Magnetic resonance imaging is the most sensitive method for detecting acute or chronic changes in SpA patients with histories of inflammatory low back pain and normal or indeterminate findings on plain radiographs.

EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice

“…Heuft-Dorenborsch et al found that initial assessment of structural changes by radiography followed by MRI assessment of inflammation with negative radiography gives the highest returns for detecting involvement of the SI joint in patients with recent IBP 27. Finally, two studies found MRI of the SI joint superior to QSS or radiography for diagnosing sacroiliitis in IBP and SpA 14 33…”

The diagnostic value of scintigraphy in assessing sacroiliitis in ankylosing spondylitis: a systematic literature research

“…In 12 these 23 studies the cut-off was even more precisely defined by calculating the mean radiotracer uptake in controls plus twice the standard deviation,24 28 34 36 – 44 here the mean tracer uptake was 1.48 (SD 0.18). Two studies even used different age groups to define reference values 42 45…”

“…In two studies including a total of 37 patients with AS35 45 the pooled sensitivity of scintigraphy to detect acute sacroiliitis was 59.5% (22 of 37) compared with MRI as a gold standard (fig 3). Jee et al 35 found that of 11 patients with AS with a positive MRI six patients with AS also had a positive scintigraphy, here a κ value (for the comparison of scintigraphy and MRI) of 0.33 could be calculated.…”

Clinical and genetic factors associated with sacroiliitis in Crohn's disease

“…Recognition of SI on radiographs of the sacroiliac joints is difficult and requires experience. Many studies have addressed the inter‐ and intra‐observer variability of this technique and CT and MRI scans have proven to be more sensitive and specific 3,15–17,41 . Nevertheless, due to the limited availability, high radiation exposure and/or relative high cost of these techniques, plain sacroiliac radiographs remain the initial diagnostic tool 11,18 .…”