The investigation of sacroiliitis with different imaging techniques in spondyloarthropathies
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The aim of this study was to compare the value of different imaging techniques in spondyloarthropathy (SpA) patients with inflammatory low back pain.
Patients and methods
We evaluated 54 patients who fulfilled the European spondyloarthropathy classification criteria and had inflammatory low back pain. They were subdivided into two groups according to changes on plain radiography rated on a 0–4 scale according to modified New York criteria. Group A patients had at least grade-2 unilateral or bilateral changes in the sacroiliac (SI) joints, whereas group B included patients with radiologic changes not exceeding grade 0–1. Quantitative SI scintigraphy and magnetic resonance imaging (MRI) were performed to investigate the value of these techniques to the diagnosis of sacroiliitis, and the sacroiliac joint:sacrum uptake ratios were calculated. Scintiscanning was done in 80 healthy subjects to define the normal range.
The sensitivities of plain radiography, quantitative SI scintigraphy, and MRI were 61%, 55%, and 89%, respectively, among the patients with SpA. MRI and quantitative SI scintigraphy detected sacroiliitis in 97% and 49% of group A, respectively. In group B, these results were 76% and 66%, respectively.
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.
KeywordsMagnetic resonance imaging Plain radiography Quantitative sacroiliac scintigraphy Sacroiliitis Spondyloarthropathies
- 1.Dougados M, van der Linden S, Juhlin R, Huitfeldt B, Amor B, Calin A, Cats A, Dijkmans B, Olivieri I, Pasero G, Veys E, Zeidler H, European Spondylarthropathy Study Group (1991) The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum 34:1218–1227PubMedGoogle Scholar
- 4.Khan MA (2002) Thoughts concerning the early diagnosis of ankylosing spondylitis and related diseases. Clin Exp Rheumatol 20 [Suppl 28]:6–10Google Scholar
- 6.Holder LE, Fogelman I, Collier BD (2000) An atlas of planar and SPECT bone scans. Second edn. Dunitz, LondonGoogle Scholar
- 7.Şen F (2003) Assessment of the effects of age and gender on obtaining normal sacroiliac index values in quantitative bone scintigraphy (thesis). University of Marmara, IstanbulGoogle Scholar
- 10.Khan MA (2002) Ankylosing spondylitis: introductory comments on its diagnosis and treatment. Ann Rheum Dis 61 [Suppl 3]:3–7Google Scholar
- 17.Blum U, Buitrago-Tellez C, Mundinger A, Krause T, Laubenberger J, Vaith P, Peter HH, Langer M (1996) Magnetic resonance imaging (MRI) for detection of active sacroiliitis—a prospective study comparing conventional radiography, scintigraphy and contrast enhanced MRI. J Rheumatol 23:2107–2115PubMedGoogle Scholar