Skeletal Radiology

, Volume 27, Issue 11, pp 606–616

Use of contrast-enhanced MR imaging to detect sacroiliitis in children

  • M. Bollow
  • Jürgen Braun
  • Thomas Biedermann
  • Sven Mutze
  • Stefan Paris
  • Christina Schauer-Petrowskaja
  • Kerstin Minden
  • Stephan A. Schmitz
  • Monika Schöntube
  • Bernd Hamm
ARTICLE

DOI: 10.1007/s002560050446

Cite this article as:
Bollow, M., Braun, J., Biedermann, T. et al. Skeletal Radiol (1998) 27: 606. doi:10.1007/s002560050446

Abstract 

Purpose. To verify the diagnostic value of contrast-enhanced MR imaging compared with conventional radiography in the diagnosis of sacroiliitis in children. Design and patients. Radiography and MR imaging of the sacroiliac joints were performed in 185 children subdivided into the following groups according to the modified European Spondyloarthropathy (SpA) Study Group (ESSG) criteria: group 1, undifferentiated spondyloarthropathy (uSpA) (n=53, 94.5% HLA-B27+); group 2, differentiated SpA (n=45, 93.3% HLA-B27+); group 3, patients with no signs of SpA other than oligoarthritis (n=39, 92.3% HLA-B27+); group 4, HLA-B27+ controls with various other non-SpA diagnoses (n=22); and group 5, HLA-B27– controls with various other non-SpA diagnoses (n=26). Radiographs were evaluated on the basis of the modified New York criteria independently by three experienced radiologists masked to the clinical data. In a second step, the same radiologists independently evaluated the MR images without knowledge of the clinical data and radiographic findings using the recently published criteria developed by our group. These criteria allow differentiation of acute and chronic inflammatory changes. Results. Radiography demonstrated sacroiliitis in 18 patients: 4 of 53 in group 1 (7.5%), 14 of 45 in group 2 (31%), but none in groups 3, 4 and 5. In contrast, MR imaging demonstrated acute and/or chronic sacroiliitis in 44 patients: 18 of 53 in group 1 (34%), 21 of 45 in group 2 (46.7%) and 5 of 39 in group 3 (12.8%), but none in groups 4 and 5. The percentage of sacroiliitis detected by MR imaging was significantly higher than that detected by radiography (P<0.001). Conclusion. Contrast-enhanced MR imaging is a useful method for detecting sacroiliitis in children. Advantages of contrast-enhanced MR imaging compared with conventional radiography are a higher sensitivity due to the ability to document early and acute changes and the absence of radiation exposure.

Key words MR imaging Sacroiliitis Spondyloarthropathy Arthritis in infants and children 

Copyright information

© International Skeletal Society 1998

Authors and Affiliations

  • M. Bollow
    • 1
  • Jürgen Braun
    • 2
  • Thomas Biedermann
    • 3
  • Sven Mutze
    • 1
  • Stefan Paris
    • 1
  • Christina Schauer-Petrowskaja
    • 3
  • Kerstin Minden
    • 3
  • Stephan A. Schmitz
    • 4
  • Monika Schöntube
    • 3
  • Bernd Hamm
    • 1
  1. 1.Department of Radiology, Charité Campus Mitte, Humboldt-Universität zu Berlin, Schumannstrasse 20–21, D-10098 Berlin, GermanyDE
  2. 2.Department of General Internal Medicine and Rheumatology, Klinikum Benjamin Franklin, Freie Universität Berlin, Hindenburgdamm 30, D-12200 Berlin, GermanyDE
  3. 3.Department of Juvenile Rheumatology, II. Kinderklinik, Krankenhaus Berlin Buch, Wittbergstrasse 50, D-13125 Berlin, GermanyDE
  4. 4.Department of Radiology and Nuclear Medicine, Klinikum Benjamin Franklin, Freie Universität Berlin, Hindenburgdamm 30, D-12200 Berlin, GermanyDE