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Sacroiliac joints: anatomical variations on MR images

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To describe the appearance of the anatomical variations of the sacroiliac joints (SIJ) on MR images and to highlight the potential MR features that might be misleading.

Methods

Consecutive MRI examinations of SIJs performed at our department from January 2015 to December 2016 were retrospectively analyzed. As one of our goals was to describe potential misleading edematous or structural changes associated with SIJ anatomical variations, patients fulfilling the ASAS criteria were excluded from this study to ensure that signal intensity changes would not be related to sacroiliitis. Five anatomical variations and a dysmorphic appearance of the SIJ were detected.

Results

The final group consisted of 157 patients. Unilateral or bilateral anatomical variations of the SIJ were found in 50 patients (accessory SIJ, iliosacral complex and sacral defect in 17, 18 and 21 patients, respectively, and synostosis in one patient). A dysmorphic appearance of the SIJ was found in 26 patients. No case of an unfused ossification centers was depicted. Structural and/or edematous changes of the facing bones were quite frequently observed in accessory and dysmorphic SIJ. Iliosacral complex and sacral defects could be associated with prominent vessels running along their bony surfaces.

Conclusion

Several anatomical variations of the SIJs are relatively commonly seen on MR images, particularly in females. These variations may be associated with signal intensity changes, which may be mechanical and not necessarily inflammatory in nature.

Key points

• Anatomical variations of SIJ may involve the cartilaginous or ligamentous part of the joint

• Anatomical variations of SIJ are sometimes associated with edematous and/or structural changes of the adjacent bone

• Anatomical variations of the SIJ can be misleading on MR imaging

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Abbreviations

CI:

Confidence intervals

CT:

Computed tomography

MRI:

Magnetic resonance imaging

SIJ:

Sacroiliac joints

SpA:

Spondyloarthritis

SPAIR:

Spectral attenuated inversion recovery

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Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Musculoskeletal Radiology Department, Lille University Hospital, 59037, Lille, France

    Mazen El Rafei, Sammy Badr, Guillaume Lefebvre, Benoist Capon & Anne Cotten

  2. Unite de methodologie biostatistique et data management Maison regionale de la recherche clinique CHRU Lille, Lille, France

    Francois Machuron

  3. Department of Rheumatology, Lille University Hospital, 59037, Lille, France

    Rene-Marc Flipo

Authors
  1. Mazen El Rafei
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  2. Sammy Badr
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  3. Guillaume Lefebvre
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  4. Francois Machuron
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  5. Benoist Capon
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  6. Rene-Marc Flipo
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  7. Anne Cotten
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Corresponding author

Correspondence to Anne Cotten.

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Guarantor

The scientific guarantor of this publication is Prof. Anne Cotten.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because it was a retrospective study

Ethical approval

Institutional Review Board approval was obtained: This study was conducted in accordance with our local review board recommendations and with the Declaration of Helsinki.

Methodology

• retrospective

• observational

• performed at one institution

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Cite this article

El Rafei, M., Badr, S., Lefebvre, G. et al. Sacroiliac joints: anatomical variations on MR images. Eur Radiol 28, 5328–5337 (2018). https://doi.org/10.1007/s00330-018-5540-x

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  • DOI: https://doi.org/10.1007/s00330-018-5540-x

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