TY - JOUR

T1 - MRI of the sacroiliac joints

T2 - What is and what is not sacroiliitis?

AU - Østergaard, Mikkel

PY - 2020

Y1 - 2020

N2 - Purpose of reviewMRI has, as the only imaging modality, the ability to visualize both the inflammatory and destructive aspects of sacroiliitis and is a crucial element in the diagnosis and classification of axial spondyloarthritis (axSpA). However, the MRI appearance of several potential differential diagnoses may resemble axSpA sacroiliitis.Recent findingsThe appearances of sacroiliac joint (SIJ) MRIs of various diseased and healthy populations have recently been intensively studied. BME, the key requirement in the Assessment of Spondyloarthritis international Society (ASAS) definition of a 'MRI positive of sacroiliitis' may also be found in degenerative disease, athletes and healthy persons, and, particularly, postpartum women. Certain pattern of BME (high extent, large depth from articular surface, close relation to other lesion types) as well as the presence of structural lesions, particularly bone erosion, backfill or ankylosis increase the likelihood/specificity of being axSpA. Furthermore, old and novel MRI approaches to best distinguish the sacroiliitis of early axSpA from differential diagnoses have recently been tested and compared.SummarySignificant new and clinically relevant knowledge has been gained, but further research is still needed to optimally distinguish what is and what isn't sacroiliitis.

AB - Purpose of reviewMRI has, as the only imaging modality, the ability to visualize both the inflammatory and destructive aspects of sacroiliitis and is a crucial element in the diagnosis and classification of axial spondyloarthritis (axSpA). However, the MRI appearance of several potential differential diagnoses may resemble axSpA sacroiliitis.Recent findingsThe appearances of sacroiliac joint (SIJ) MRIs of various diseased and healthy populations have recently been intensively studied. BME, the key requirement in the Assessment of Spondyloarthritis international Society (ASAS) definition of a 'MRI positive of sacroiliitis' may also be found in degenerative disease, athletes and healthy persons, and, particularly, postpartum women. Certain pattern of BME (high extent, large depth from articular surface, close relation to other lesion types) as well as the presence of structural lesions, particularly bone erosion, backfill or ankylosis increase the likelihood/specificity of being axSpA. Furthermore, old and novel MRI approaches to best distinguish the sacroiliitis of early axSpA from differential diagnoses have recently been tested and compared.SummarySignificant new and clinically relevant knowledge has been gained, but further research is still needed to optimally distinguish what is and what isn't sacroiliitis.

KW - diagnosis

KW - MRI

KW - sacroiliac joint

KW - sacroiliitis

KW - spondyloarthritis

U2 - 10.1097/BOR.0000000000000718

DO - 10.1097/BOR.0000000000000718

M3 - Review

C2 - 32453038

AN - SCOPUS:85085586121

VL - 32

SP - 357

EP - 364

JO - Current Opinion in Rheumatology

JF - Current Opinion in Rheumatology

SN - 1040-8711

IS - 4

ER -