Clinical Rheumatology

, 28:1007 | Cite as

Imaging of the sacroiliac joint involvement in seronegative spondylarthropathies

  • Giuseppe Guglielmi
  • Giacomo Scalzo
  • Alessia Cascavilla
  • Marina Carotti
  • Fausto Salaffi
  • Walter Grassi
Review Article


Involvement of the sacroiliac joints is the first predominant finding of all seronegative spondylarthropathies (SpA) subsets, such as ankylosing spondylitis, psoriatic arthritis, and undifferentiated SpA. Although conventional radiography is indicated in the initial evaluation of sacroiliac joints diseases, it is often insensitive for demonstrating the early changes of sacroiliitis, so other imaging techniques typically are often necessary to clarify the pathology and for establishing the early diagnosis of seronegative SpA. Other imaging modalities, including computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US), and bone scintigraphy have improved visualization of inflammatory changes at the sacroiliac joints (SIJ). CT scans are indicated for disease processes in which bony destruction or ossification may occur. MRI has been proposed as an imaging method to detect sacroiliitis earlier. MRI can identify both inflammation and structural changes caused by inflammation, while radiographs show only structural changes. MRI may be particularly useful in making a diagnosis of SpA. Musculoskeletal US has an increasing and relevant role in the evaluation of SpA mainly for its ability to assess joint and periarticular soft tissue involvement and in particular for its capacity to detect enthesitis. US assessment in general is safe, noninvasive, and comparably cheap, showing itself as a complimentary tool to clinical evaluation in SpA; nevertheless, it is very user dependent. Bone scintigraphy is at most of limited diagnostic value for the diagnosis of established AS, including the early diagnosis of probable/suspected sacroiliitis. The main aim of this study is to introduce the clinical and radiological aspects of the SIJ involvement in SpA, particularly the contribution of the different imaging techniques.


Computed tomography Inflammatory back pain Magnetic resonance imaging Sacroiliac joint Sacroiliitis Seronegative spondylarthropathies 





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Copyright information

© Clinical Rheumatology 2009

Authors and Affiliations

  • Giuseppe Guglielmi
    • 1
    • 2
  • Giacomo Scalzo
    • 1
  • Alessia Cascavilla
    • 1
  • Marina Carotti
    • 3
  • Fausto Salaffi
    • 4
  • Walter Grassi
    • 4
  1. 1.Department of RadiologyUniversity of FoggiaFoggiaItaly
  2. 2.Department of RadiologyScientific Institute Hospital “CSS”FoggiaItaly
  3. 3.Department of RadiologyUniversity of Ancona, Hospital TorretteAnconaItaly
  4. 4.Department of RheumatologyUniversità Politecnica delle MarcheJesiItaly

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