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Arthritis 2: Sacroiliac Joint

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Imaging of the Hip & Bony Pelvis

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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19.7 Conclusion

Anteroposterior (AP) or PA radiography of the SIJs is a widely used screening examination in patient’s suspected of sacroiliitis. The sensitivity and specificity of radiography is relatively low, and the diagnosis of sacroiliitis may be delayed when based on radiography. Cross-sectional imaging therefore plays an important role in identification of abnormalities of the SIJs in early seronegative SpA. MR imaging and CT have almost equal efficacy superior to radiography in staging joint destruction as part of sacroiliitis, but MR imaging in addition allows visualisation and grading of active inflammatory changes in the joint space, subchondral bone, and surrounding ligaments. MR imaging is therefore preferable diagnostically in the evaluation of sacroiliitis and is not associated with radiation. There is not yet an established, widely accepted method for evaluation and quantification of MR abnormalities. It is therefore difficult at the moment to include MR findings in staging criteria for AS, and in the elaboration of diagnostic criteria for other forms of SpA. Proposals for grading MR abnormalities are currently under evaluation; hopefully resulting in future accepted diagnostic criteria. There is no doubt that the capability of MR imaging to distinguish between acute and chronic changes, and to estimate the degree of disease activity, can be beneficial with regard to classification of the different forms of SpA and for monitoring the disease course, including the effect of pharmacological treatment. Where possible, MR imaging should therefore be used for the evaluation of sacroiliitis in SpA, offering the advantage of being able to exclude infection, which is the most important differential diagnosis.

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Authors and Affiliations

  1. Department of Radiology, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark

    Anne Grethe Jurik MD, DMSc (Associate Professor)

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  1. Anne Grethe Jurik MD, DMSc
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Editors and Affiliations

  1. The MRI Centre, Royal Orthopaedic Hospital, Birmingham, B31 2AP, UK

    A. Mark Davies MD (Consultant Radiologist) (Consultant Radiologist)

  2. Princess of Wales, Birmingham Children’s Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK

    Karl J. Johnson MD (Consultant Paediatric Radiologist) (Consultant Paediatric Radiologist)

  3. Department of Clinical Radiology, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK

    Richard William Whitehouse MD

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© 2006 Springer-Verlag Berlin Heidelberg

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Jurik, A.G. (2006). Arthritis 2: Sacroiliac Joint. In: Davies, A.M., Johnson, K.J., Whitehouse, R.W. (eds) Imaging of the Hip & Bony Pelvis. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-30000-7_19

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  • DOI: https://doi.org/10.1007/3-540-30000-7_19

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-20640-8

  • Online ISBN: 978-3-540-30000-7

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