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Seronegative spondyloarthropathy-related sacroiliitis: CT, MRI features and differentials.

Prakash D, Prabhu SM, Irodi A - Indian J Radiol Imaging (2014)

Bottom Line: Seronegative spondyloarthropathy is a group of chronic inflammatory rheumatic diseases that predominantly affect the axial skeleton.Involvement of sacroiliac joint is considered a hallmark for diagnosis of seronegative spondyloarthropathy and is usually the first manifestation of this condition.We present a pictorial essay of CT and MRI imaging findings in seronegative spondyloarthropathy-related sacroiliitis in various stages and highlight common differentials that need to be considered.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India.

ABSTRACT
Seronegative spondyloarthropathy is a group of chronic inflammatory rheumatic diseases that predominantly affect the axial skeleton. Involvement of sacroiliac joint is considered a hallmark for diagnosis of seronegative spondyloarthropathy and is usually the first manifestation of this condition. It is essential for the radiologist to know the computed tomography (CT) and magnetic resonance imaging (MRI) features of spondyloarthropathy-related sacroiliitis as imaging plays an important role in diagnosis and evaluation of response to treatment. We present a pictorial essay of CT and MRI imaging findings in seronegative spondyloarthropathy-related sacroiliitis in various stages and highlight common differentials that need to be considered.

No MeSH data available.


Related in: MedlinePlus

Infective sacroiliitis. (A) Oblique coronal STIR MR image through sacroiliac joint in a 19 year old female shows left sacroiliitis with bone marrow edema (white arrow) and widening of joint space (black arrow). (B) Coronal STIR MRI image of pelvis shows muliple surrounding hyperintense collections suggesting infective sacroiliitis (white arrow). (C) Axial T1W MRI image in another patient with infective sacroiliitis shows right sacroiliitis with bone marrow edema, subchondral erosions, and joint space widening (black arrow). (D) Axial T2W MRI image in the same patient shows bone marrow edema, subchondral erosions, and joint space widening (black arrow) with multiple surrounding hyperintense soft tissue collections in the right gluteal region (long white arrow) and sinus tract extending upto the overlying skin (short white arrow)
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Figure 13: Infective sacroiliitis. (A) Oblique coronal STIR MR image through sacroiliac joint in a 19 year old female shows left sacroiliitis with bone marrow edema (white arrow) and widening of joint space (black arrow). (B) Coronal STIR MRI image of pelvis shows muliple surrounding hyperintense collections suggesting infective sacroiliitis (white arrow). (C) Axial T1W MRI image in another patient with infective sacroiliitis shows right sacroiliitis with bone marrow edema, subchondral erosions, and joint space widening (black arrow). (D) Axial T2W MRI image in the same patient shows bone marrow edema, subchondral erosions, and joint space widening (black arrow) with multiple surrounding hyperintense soft tissue collections in the right gluteal region (long white arrow) and sinus tract extending upto the overlying skin (short white arrow)

Mentions: Infective sacroiliitis: Infectious sacroiliitis [Figure 13] should be considered in the presence of unilateral joint involvement and disproportionate bone marrow edema involving either iliac or sacral surface with presence of collection extending into the surrounding soft tissue. However, it is important to note that in some early cases of spondyloarthropathy-related sacroiliitis, unilateral joint edema with disproportionate iliac side edema can be seen.[9] In such cases, the presence of surrounding soft tissue collection favors an infective etiology. Infective sacroiliitis is treated with antibiotics based on the organism isolated by CT-guided joint fluid/soft tissue collection aspiration and blood cultures


Seronegative spondyloarthropathy-related sacroiliitis: CT, MRI features and differentials.

Prakash D, Prabhu SM, Irodi A - Indian J Radiol Imaging (2014)

Infective sacroiliitis. (A) Oblique coronal STIR MR image through sacroiliac joint in a 19 year old female shows left sacroiliitis with bone marrow edema (white arrow) and widening of joint space (black arrow). (B) Coronal STIR MRI image of pelvis shows muliple surrounding hyperintense collections suggesting infective sacroiliitis (white arrow). (C) Axial T1W MRI image in another patient with infective sacroiliitis shows right sacroiliitis with bone marrow edema, subchondral erosions, and joint space widening (black arrow). (D) Axial T2W MRI image in the same patient shows bone marrow edema, subchondral erosions, and joint space widening (black arrow) with multiple surrounding hyperintense soft tissue collections in the right gluteal region (long white arrow) and sinus tract extending upto the overlying skin (short white arrow)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126143&req=5

Figure 13: Infective sacroiliitis. (A) Oblique coronal STIR MR image through sacroiliac joint in a 19 year old female shows left sacroiliitis with bone marrow edema (white arrow) and widening of joint space (black arrow). (B) Coronal STIR MRI image of pelvis shows muliple surrounding hyperintense collections suggesting infective sacroiliitis (white arrow). (C) Axial T1W MRI image in another patient with infective sacroiliitis shows right sacroiliitis with bone marrow edema, subchondral erosions, and joint space widening (black arrow). (D) Axial T2W MRI image in the same patient shows bone marrow edema, subchondral erosions, and joint space widening (black arrow) with multiple surrounding hyperintense soft tissue collections in the right gluteal region (long white arrow) and sinus tract extending upto the overlying skin (short white arrow)
Mentions: Infective sacroiliitis: Infectious sacroiliitis [Figure 13] should be considered in the presence of unilateral joint involvement and disproportionate bone marrow edema involving either iliac or sacral surface with presence of collection extending into the surrounding soft tissue. However, it is important to note that in some early cases of spondyloarthropathy-related sacroiliitis, unilateral joint edema with disproportionate iliac side edema can be seen.[9] In such cases, the presence of surrounding soft tissue collection favors an infective etiology. Infective sacroiliitis is treated with antibiotics based on the organism isolated by CT-guided joint fluid/soft tissue collection aspiration and blood cultures

Bottom Line: Seronegative spondyloarthropathy is a group of chronic inflammatory rheumatic diseases that predominantly affect the axial skeleton.Involvement of sacroiliac joint is considered a hallmark for diagnosis of seronegative spondyloarthropathy and is usually the first manifestation of this condition.We present a pictorial essay of CT and MRI imaging findings in seronegative spondyloarthropathy-related sacroiliitis in various stages and highlight common differentials that need to be considered.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India.

ABSTRACT
Seronegative spondyloarthropathy is a group of chronic inflammatory rheumatic diseases that predominantly affect the axial skeleton. Involvement of sacroiliac joint is considered a hallmark for diagnosis of seronegative spondyloarthropathy and is usually the first manifestation of this condition. It is essential for the radiologist to know the computed tomography (CT) and magnetic resonance imaging (MRI) features of spondyloarthropathy-related sacroiliitis as imaging plays an important role in diagnosis and evaluation of response to treatment. We present a pictorial essay of CT and MRI imaging findings in seronegative spondyloarthropathy-related sacroiliitis in various stages and highlight common differentials that need to be considered.

No MeSH data available.


Related in: MedlinePlus