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Scientific Reports Jul 2020Sacroiliac joint involvement is one of the earliest manifestations of psoriatic arthritis (PsA). Magnetic resonance imaging (MRI) is a useful tool in the early diagnosis...
Sacroiliac joint involvement is one of the earliest manifestations of psoriatic arthritis (PsA). Magnetic resonance imaging (MRI) is a useful tool in the early diagnosis of axial disease due to its sensitivity for detecting acute and chronic changes associated with sacroiliitis. In this study, we evaluated the prevalence of sacroiliitis, acute and structural image changes on MRI in PsA patients and identified predictive clinical, laboratory and disease activity factors. Cross-sectional study on PsA patients submitted to MRI of the sacroiliac joints. The scans were evaluated by two blinded radiologists and the level of agreement was calculated (kappa). Clinical, disease activity and quality-of-life indices (DAS28, BASDAI, PASI, MASES, HAQ, CRP, ESR) were estimated. The sample consisted of 45 PsA patients with a mean age of 50.1 ± 11.5 years. The prevalence of sacroiliitis was 37.8% (n = 17), 47% of which was unilateral. The kappa coefficient was 0.64. Only 5 (29.4%) of the 17 patients with sacroiliitis on MRI had back pain. The most prevalent acute and chronic changes on MRI were, respectively, subchondral bone edema (26.7%) and enthesitis (20%), periarticular erosions (26.7%) and fat metaplasia (13.3%). CRP levels were higher among sacroiliitis patients (p = 0.028), and time of psoriasis was positively associated with chronic lesions (p = 0.006). Sacroiliitis on MRI was highly prevalent in our sample of PsA patients. Raised CRP levels were significantly associated with sacroiliitis, and longer time of psoriasis was predictive of chronic sacroiliitis lesions. Most sacroiliitis patients displayed no clinical symptoms.
Topics: Adult; Aged; Arthritis, Psoriatic; Early Diagnosis; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Sacroiliitis
PubMed: 32665619
DOI: 10.1038/s41598-020-68456-7 -
SAGE Open Medical Case Reports 2021Lumbo-pelvic pain is a common and non-specific problem during pregnancy and postpartum. Although perinatal pyogenic sacroiliitis is uncommon during this time, it might...
Lumbo-pelvic pain is a common and non-specific problem during pregnancy and postpartum. Although perinatal pyogenic sacroiliitis is uncommon during this time, it might be difficult to distinguish from reactive sacroiliitis in women who are experiencing significant lower back and pelvic girdle pain, as the symptoms and signs are not clear and the tests are not definitive. A 34-year-old primigravida went to the emergency department with severe lower back pain radiating to the right gluteal region and down to the back of the right thigh. This pain began 12 days prior to her presentation and eventually worsened to the point that she could not stand or walk. Her vital signs were within normal ranges, and she was experiencing a fever. Apart from a slight widening of the symphysis pubis, her pelvic and lumbo-sacral pain X-rays revealed no important findings. With the clinical impression of right lumbo-pelvic pain, the patient was admitted for pain management and further inquiries. Despite the fact that the antibiotherapy was prescribed to treat a urinary tract infection, the significant recovery of the patient's symptoms, even in the absence of a definitive culture of aspirate from the right sacroiliac joint, supported the diagnosis of pyogenic sacroiliitis.
PubMed: 34659772
DOI: 10.1177/2050313X211052442 -
The Israel Medical Association Journal... Mar 2021
Topics: Acute Disease; Aged, 80 and over; Female; Gout; Humans; Sacroiliitis
PubMed: 33734634
DOI: No ID Found -
Canadian Association of Radiologists... Feb 2016Sacroiliac (SI) region pain is a common clinical presentation and is often due to pathology involving the SI joints, usually of inflammatory, infective, neoplastic, or... (Review)
Review
Sacroiliac (SI) region pain is a common clinical presentation and is often due to pathology involving the SI joints, usually of inflammatory, infective, neoplastic, or post-traumatic etiology. The SI joints have a unique anatomic layout and composition and can be imaged with a variety of techniques including conventional radiographs, computed tomography, isotope bone scintigraphy, and magnetic resonance imaging. This article reviews a range of common SI joint conditions, illustrated by multimodality imaging findings. We also discuss strategies for choosing the optimal imaging modality, pearls, and pitfalls of imaging and discuss an algorithm for approaching the patient with suspected inflammatory back pain.
Topics: Aged; Algorithms; Humans; Inflammation; Joint Diseases; Magnetic Resonance Imaging; Male; Pain; Sacroiliac Joint; Spondylarthropathies; Spondylitis, Ankylosing; Tomography, X-Ray Computed
PubMed: 26632100
DOI: 10.1016/j.carj.2015.08.001 -
Arthritis & Rheumatology (Hoboken, N.J.) Jan 2016
Topics: Contrast Media; Female; Gadolinium; Humans; Male; Sacroiliitis; Spondylarthropathies; Synovitis
PubMed: 26474419
DOI: 10.1002/art.39456 -
Rheumatic Diseases Clinics of North... Nov 2013Spondyloarthritis (SpA) encompasses a group of disorders linked by overlapping clinical manifestations and genetic predisposition. Newer classification systems developed... (Review)
Review
Spondyloarthritis (SpA) encompasses a group of disorders linked by overlapping clinical manifestations and genetic predisposition. Newer classification systems developed for adults with SpA focus on identifying individuals with axial or predominantly peripheral involvement. All forms of SpA can begin during childhood, and can be considered on a continuum with adult disease. Nevertheless, there are important differences in presentation and outcome that depend on age at onset. This article highlights these differences, what has been learned about genetics and pathogenesis of SpA, and important unmet needs for future studies.
Topics: Adolescent; Antirheumatic Agents; Arthritis, Psoriatic; Arthritis, Reactive; Child; Humans; Inflammatory Bowel Diseases; Sacroiliitis; Spondylarthropathies; Spondylitis, Ankylosing
PubMed: 24182854
DOI: 10.1016/j.rdc.2013.06.002 -
Quantitative Imaging in Medicine and... Feb 2019The clinical need to diagnose sacroiliitis at an earlier stage has led to the sacroiliac joints being more frequently imaged, particularly with magnetic resonance... (Review)
Review
The clinical need to diagnose sacroiliitis at an earlier stage has led to the sacroiliac joints being more frequently imaged, particularly with magnetic resonance imaging (MRI). This review outlines the imaging approach to sacroiliitis, emphasizing the imaging protocols, diagnostic criteria, limitations and potential mimics of MRI examination. The value of imaging-guided intervention in sacroiliac joint disease is also briefly outlined.
PubMed: 30976556
DOI: 10.21037/qims.2018.11.10 -
Diagnostics (Basel, Switzerland) Feb 2023The ability of microwave radiometry (MWR) to detect with high accuracy in-depth temperature changes in human tissues is under investigation in various medical fields.... (Review)
Review
The ability of microwave radiometry (MWR) to detect with high accuracy in-depth temperature changes in human tissues is under investigation in various medical fields. The need for non-invasive, easily accessible imaging biomarkers for the diagnosis and monitoring of inflammatory arthritis provides the background for this application in order to detect the local temperature increase due to the inflammatory process by placing the appropriate MWR sensor on the skin over the joint. Indeed, a number of studies reviewed herein have reported interesting results, suggesting that MWR is useful for the differential diagnosis of arthritis as well as for the assessment of clinical and subclinical inflammation at the individual large or small joint level and the patient level. MWR showed higher agreement with musculoskeletal ultrasound, used as a reference, than with clinical examination in rheumatoid arthritis (RA), while it also appeared useful for the assessment of back pain and sacroiliitis. Further studies with a larger number of patients are warranted to confirm these findings, taking into account the current limitations of the available MWR devices. This may lead to the production of easily accessible and inexpensive MWR devices that will provide a powerful impetus for personalized medicine.
PubMed: 36832097
DOI: 10.3390/diagnostics13040609 -
Journal of Digital Imaging Feb 2022Spondyloarthritis (SpA) is a group of diseases primarily involving chronic inflammation of the spine and peripheral joints, as evaluated by magnetic resonance imaging...
Spondyloarthritis (SpA) is a group of diseases primarily involving chronic inflammation of the spine and peripheral joints, as evaluated by magnetic resonance imaging (MRI). Considering the complexity of SpA, we performed a retrospective study to discover quantitative/radiomic MRI-based features correlated with SpA. We also investigated different fat-suppression MRI techniques to develop detection models for inflammatory sacroiliitis. Finally, these model results were compared with those of experienced musculoskeletal radiologists, and the concordance level was evaluated. Examinations of 46 consecutive patients were obtained using SPAIR (spectral attenuated inversion recovery) and STIR (short tau inversion recovery) MRI sequences. Musculoskeletal radiologists manually segmented the sacroiliac joints for further extraction of 230 MRI features from gray-level histogram/matrices and wavelet filters. These features were associated with sacroiliitis, SpA, and the current biomarkers of ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), BASDAI (Bath Ankylosing Spondylitis Activity Index), BASFI (Bath Ankylosing Spondylitis Functional Index), and MASES (Maastricht Ankylosing Spondylitis Enthesis Score). The Mann-Whitney U test showed that the radiomic markers from both MRI sequences were associated with active sacroiliitis and with SpA and its axial and peripheral subtypes (p < 0.05). Spearman's coefficient also identified a correlation between MRI markers and data from clinical practice (p < 0.05). Fat-suppression MRI models yielded performances that were statistically equivalent to those of specialists and presented strong concordance in identifying inflammatory sacroiliitis. SPAIR and STIR acquisition protocols showed potential for the evaluation of sacroiliac joints and the composition of a radiomic model to support the clinical assessment of SpA.
Topics: Biomarkers; Humans; Magnetic Resonance Imaging; Retrospective Studies; Sacroiliac Joint; Sacroiliitis; Spondylarthritis; Spondylitis, Ankylosing
PubMed: 34997373
DOI: 10.1007/s10278-021-00559-7 -
Journal of Clinical Medicine Feb 2021. To describe the clinical characteristics, predictors and treatment of children with Enthesitis Related Arthritis (ERA) in a Singapore longitudinal cohort over 11...
Enthesitis Related Arthritis in a Longitudinal Southeast Asian Registry: High Prevalence of HLA-B27, Different Sacroiliitis Risk Factors and Less Common Drug-Free Remission.
. To describe the clinical characteristics, predictors and treatment of children with Enthesitis Related Arthritis (ERA) in a Singapore longitudinal cohort over 11 years. . ERA patients were recruited from our registry (2009-2019). Nonparametric descriptive statistics including median (interquartile range, IQR) were used to describe data. Kaplan-Meier survival and logistic/Cox regression analyses were used to estimate the probabilities and determine predictors of clinical variables, respectively. The significance level was set at <0.05. . One hundred and forty-six ERA patients (87% male, 82% Chinese) were included. Median onset age was 11.9 years (IQR 9.4-14.0) and median disease duration was 4.9 years (IQR 2.6-8.3). Family history of Human Leukocyte Antigen (HLA)-B27 associated diseases was positive in 7.5%. Acute uveitis occurred in 3.4%. Oligoarthritis was present in 89.7%. Hip, knee and ankle joints were among the most common joints involved. One-fourth had enthesitis at diagnosis (Achilles tendon entheses, 82.9%). Sacroiliitis occurred in 61%. Probabilities of sacroiliitis development were 0.364, 0.448 and 0.578 at 1, 2 and 5 years after onset, respectively. Negative HLA-B27, female, older age at onset and hip arthritis at diagnosis were associated with shorter time for sacroiliitis development ( = 0.001-0.049). Methotrexate (MTX) remained the most common disease modifying anti-rheumatic drug (DMARD) used (77.4%). However, 77.9% required anti-TNF (aTNF) therapy secondary to MTX failure. Among MTX-treated sacroiliitis patients, 85.3% failed, requiring aTNF, as compared to 63.2%patients without axial disease. Longer duration to diagnosis ( = 0.038) and MTX use ( = 0.007) predicted aTNF therapy. None had joint deformity. . This study underscores differences in ERA clinical characteristics, predictors and treatment responses. Our ERA population had many unique findings but good functional outcomes.
PubMed: 33546269
DOI: 10.3390/jcm10040568