MRI of the sacroiliac joints in athletes: recognition of non-specific bone marrow oedema by semi-axial added to standard semi-coronal scans

被引：31

作者：

Weber, Ulrich ^{[1
,2
,3
]}

Jurik, Anne Grethe ^{[4
,5
]}

Zejden, Anna ^{[4
]}

Larsen, Ejnar ^{[6
]}

Jorgensen, Steen Hylgaard ^{[7
]}

Rufibach, Kaspar ^{[8
,9
]}

Schioldan, Christian ^{[10
]}

Schmidt-Olsen, Soren ^{[11
]}

机构：

[1] Univ Hosp Southern Denmark, Danish Hosp Rheumat Dis, Engelshojgade 9A, DK-6400 Sonderborg, Denmark

[2] Univ Hosp Reg Southern Denmark, Hosp Southern Jutland, Aabenraa, Denmark

[3] Univ Southern Denmark, Dept Reg Hlth Res, Odense, Denmark

[4] Aarhus Univ Hosp, Dept Radiol, Aarhus, Denmark

[5] Aarhus Univ, Dept Clin Med, Hlth, Aarhus, Denmark

[6] North Denmark Reg Hosp, Ctr Clin Res, Dept Radiol, Hjorring, Denmark

[7] North Denmark Reg Hosp, Ctr Clin Res, Dept Clin Med, Hjorring, Denmark

[8] Rufibach rePROstat EF, Biostat Consulting & Training, Meiringen, Switzerland

[9] F Hoffmann La Roche, Div Biostat, Basel, Switzerland

[10] Clin Benefit, Dept Physiotherapy, Frederikshavn, Denmark

[11] North Denmark Reg Hosp, Dept Rheumatol & Sports Med, Hjorring, Denmark

来源：

RHEUMATOLOGY | 2020年 / 59卷 / 06期

关键词：

magnetic resonance imaging; spondyloarthritis; sacroiliac joints; semi-coronal and semi-axial scans; athletes; ANKYLOSING-SPONDYLITIS; DIAGNOSTIC UTILITY; SPONDYLOARTHRITIS; SPONDYLARTHRITIS; VALIDATION; CRITERIA;

D O I：

10.1093/rheumatology/kez458

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective. Assessment of combined semi-axial and semi-coronal SI joint MRI in two cohorts of young athletes to explore frequency and topography of non-specific bone marrow oedema (BMO), its association with four constitutional SI joint features, and potential restriction of false-positive assignments of Assessment of SpondyloArthritis International Society-defined sacroiliitis on standard semi-coronal scans alone. Methods. Combined semi-axial and semi-coronal SI joint MRI scans of 20 recreational runners before/after running and 22 elite ice-hockey players were evaluated by three blinded readers for BMO and its association with four constitutional SI joint features: vascular partial volume effect, deep iliac ligament insertion, fluid-filled bone cyst and lumbosacral transitional anomaly. Scans of TNF-treated spondyloarthritis patients served to mask readers. We analysed distribution and topography of BMO and SI joint features across eight anatomical SI joint regions (upper/lower ilium/sacrum, subdivided in anterior/posterior slices) descriptively, as concordantly recorded by 2/3 readers on both MRI planes. BMO confirmed on both scans was compared with previous evaluation of semi-coronal MRI alone, which met the Assessment of SpondyloArthritis International Society definition for active sacroiliitis. Results. Perpendicular semi-axial and semi-coronal MRI scans confirmed BMO in the SI joint of every fourth young athlete, preferentially in the anterior upper sacrum. BMO associated with four constitutional SI joint features was observed in 20-36% of athletes, clustering in the posterior lower ilium. The proportion of Assessment of SpondyloArthritis International Society-positive sacroiliitis recorded on the semi-coronal plane alone decreased by 33-56% upon amending semi-axial scans. Conclusion. Semi-axial combined with standard semi-coronal scans in MRI protocols for sacroiliitis facilitated recognition of non-specific BMO, which clustered in posterior lower ilium/anterior upper sacrum.

引用

页码：1381 / 1390

页数：10