Abstract
Objective
To introduce and evaluate computed tomography (CT)-guided transarticular needle biopsy of the cartilaginous sacroiliac joint (SIJ) and to assess the biopsy results microscopically.
Materials and methods
The new CT-guided transarticular biopsy of the SIJ was performed in a young corpse and ten patients, two males and eight females aged 18–81 years. All patients had abnormal findings by magnetic resonance imaging (MRI) of the SIJs, including bone marrow edema, related to different types of joint disorders. The biopsies were focused on areas with bone marrow edema. The quality of the specimens obtained, using two different types of biopsy needles, was assessed microscopically.
Results
Biopsies containing cartilage, subchondral plate, and bone marrow from the iliac and sacral sides were obtained from the corpse and three patients and from the iliac bone only in two patients. In three patients, the biopsy needles could not penetrate the bone marrow to the joint facet due to pronounced subchondral sclerosis, but adequate marrow biopsies were obtained. Two biopsies were inadequate, one due to technical problems and one was crushed during preparation. Histological assessment of eight adequate specimens revealed inflammatory bone marrow changes, except in two specimens from females with pronounced sclerosis conforming to osteitis condensans ilii.
Conclusions
Transarticular SIJ biopsies are obtainable and can be directed towards areas with MRI abnormalities. They can be used to confirm inflammatory changes histologically. With the biopsy needles used, severe bone marrow sclerosis may hinder penetration to the cartilage, but bone marrow specimens can be obtained.
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We thank all the patients for their participation and willingness to publish their data.
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The study was not externally funded and none of the authors has conflicts of interest to disclose. The CT-guided biopsies were performed as part of a method development project intended for clinical and diagnostic purposes, approved by the institution, and permission from the Ethical Committee was waived. Informed consents for the use of clinical, imaging, and pathological data were obtained from all patients.
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Egund, N., Sørensen, F.B., Østgård, R. et al. CT-guided transarticular biopsy of the sacroiliac joint: Technique and histomorphological results. A preliminary study. Skeletal Radiol 49, 453–460 (2020). https://doi.org/10.1007/s00256-019-03305-x
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DOI: https://doi.org/10.1007/s00256-019-03305-x