Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SACROILIAC JOINT”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,027 records · Page 57Linked to original sources
PubMed2003

Imaging of sacroiliitis in early seronegative spondylarthropathy. Assessment of abnormalities by MR in comparison with radiography and CT.

PURPOSE: To analyze the type and frequency of abnormalities of the sacroiliac joint (SIJ) in early seronegative spondylarthropathy (SpA) by MR in comparison with CT and radiography, assess the most appropriate MR sequences to be used, and introduce a new way of grading MR abnormalities of the SIJ. MATERIAL AND METHODS: The SIJs of 41 patients with early SpA (median duration of inflammatory low back pain of 19 months) were evaluated by MR imaging using STIR, T1, T2, and T1 fat saturated (FS) sequences before and after i.v. Gd contrast medium followed by staging of abnormalities. The findings were compared with those obtained by CT and radiography. RESULTS: MR and CT had equal efficacy superior to radiography in staging of erosions and osseous sclerosis. Only MR allowed visualization and grading of active inflammatory changes in the subchondral bone and surrounding ligaments in addition to bone marrow fatty accumulations. T2-weighted sequences did not contribute to assessment of sacroiliitis. CONCLUSION: MR of the SIJs is reliable in its visualization of joint erosions in early SpA and allows differentiation between active and chronic sacroiliitis. We recommend the following sequences: semicoronal T1 and both semicoronal and semiaxial STIR. If these images are normal, the examination can be finished; otherwise additional semicoronal T1 FS before and after i.v. contrast has to be performed as well as semiaxial post-contrast T1 FS.

Adult↗
PubMed1991

Lytic bone lesions and polyarthritis associated with acne fulminans.

We describe a case of a male teenager, affected by acne fulminans. He had lytic bone lesions in both clavicles and arthritis of the right sacroiliac joint and spine. A bone scan showed increased uptake in these areas. Infection or a neoplastic disease was suspected but the cytological examination and the bacterial cultures of the material collected with a fine needle biopsy from the clavicular lesion were negative. The patient was treated with diclofenac and promptly recovered. Our report emphasizes that, although unusual, acne fulminans can be complicated by an erosive systemic arthritis and bone lesions. An immunological mechanism seems to be involved in this association.

Acne Vulgaris↗
PubMed1981

Computed tomography in the diagnosis of sacroiliitis.

Computed tomography (CT) and conventional radiography of the sacroiliac joint were compared in 43 patients. CT appeared to be far more sensitive and equally specific in the recognition of sacroiliitis. In a number of patients with sacroiliitis diagnosed by both techniques, CT demonstrated abnormalities that were not demonstrated by conventional radiographs. Of those patients with clinical evidence of sacroiliitis and HLA-B27 positivity, 50% had negative or equivocal radiographs compared to 19% who had negative computed tomographic images for sacroiliitis.

Adult↗
PubMed2003

Bacterial sacroiliitis probably induced by lumbar epidural analgesia.

BACKGROUND: Properly administered, lumbar epidural analgesia provides adequate pain relief during labor and delivery, and is considered to be a safe procedure with limited complications. The prevalence of infection after lumbar epidural analgesia is negligible. INTRODUCTION: Infection of the sacroiliac joint, although very close to the pucture area, has never been reported as a procedure complication. CASE: In this report, we describe a patient who experienced bacterial sacroiliitis a few days after lumbar epidural analgesia for labor. No portal of entry was identified, and we evoked a new potential risk factor that has never been proposed before, namely lumbar epidural analgesia. CONCLUSION: Sacroiliitis must be considered as a rare but serious complication of lumbar epidural analgesia.

Adult↗
PubMedDate not supplied

Bone metastases from breast cancer: guidelines for diagnosis.

OBJECTIVE: To discuss the case of a 62-year-old woman with prior history of breast cancer who later sought chiropractic care, and to present an overview of appropriate imaging procedures in such cases. CLINICAL FEATURES: The patient had a 6-month history of mild left-sided sacroiliac pain, which radiated into the left lateral thigh and leg. There was additional pain over the left upper ribs and left posterior arm, which had started insidiously. One year prior, she had undergone a lumpectomy. Current radiographs were negative for carcinoma. INTERVENTION AND OUTCOME: Cautious spinal manipulation and soft tissue procedures were used to treat her sacroiliac joints. The thoracic pain was left untreated. The patient improved over the first 7 visits but had pain return after swimming. After ceasing therapy, she still suffered from similar pain. CONCLUSIONS: It is important to assess patients who present with new bone pain after they already have a history of breast malignancy. Chiropractic physicians should take appropriate diagnostic steps to rule out suspected malignancy when there is no plain film evidence and biopsy is negative.

Bone Neoplasms↗
PubMed1991

The skeletal manifestations of brucellosis.

A prospective study of 33 patients with skeletal complications of brucellosis is reported. The diagnosis depends on the brucellar agglutination titre because the clinical, radiological and histological features are not specific, and blood culture and culture of synovial fluid are often negative. The commonest site is the sacroiliac joint, and brucellosis must be differentiated from tuberculosis as an important cause of backache. Treatment is with chemotherapy, the preferred combination being rifampicin and co-trimoxazole. Relapse can occur, but the chances can be reduced by careful clinical monitoring, and by repeated serological tests and gallium scanning; it is treated by further chemotherapy. Operation is indicated to relieve spinal cord compression or to drain a large paravertebral abscess.

Adolescent↗
PubMed1996

Fat suppressed contrast enhanced MR imaging in the assessment of sacroiliitis.

OBJECTIVE: To investigate the role of Gd-DTPA enhancement in the diagnosis of sacroiliitis. PATIENTS AND METHODS: Fifteen patients with definite sacroiliitis, five subjects from an 'equivocal group', and five controls were imaged with Fast STIR, T1-weighted with fat suppression (T1FS) before and after Gd-DTPA. The 'equivocal group' included those who had abnormally high signal on Fast STIR images only suggestive of early sacroiliitis. The enhancement factor was calculated for T1FS images. Patients graded their symptoms at the time of MR imaging. The extent of abnormal enhancement was defined as none, local, or extensive. RESULTS: Fourteen patients with definite sacroiliitis and one patient from the 'equivocal group' demonstrated abnormal Gd-DTPA enhancement of their sacroiliac joints or adjacent subchondral marrow. Correlation between the patients' symptoms and maximal enhancement of the subchondral marrow was r = 0.75, P < 0.01, and the extent of abnormal enhancement was r = 0.68, P < 0.01. CONCLUSION: Fat suppressed Gd-DTPA or Fast STIR images can be used to assess disease activity in patients with sacroiliitis. Abnormal Gd-DTPA enhancement in the 'equivocal group' is important additional evidence suggesting the diagnosis of early sacroiliitis.

Adult↗
PubMed1987

Pyogenic sacroiliitis in i.v. drug abusers.

We evaluated the sensitivity of imaging studies in six IV drug abusers who had back pain from pyogenic sacroiliitis. Initial radiographs of the sacroiliac joints showed bone destruction in two. A third had slight joint narrowing and sclerosis resembling degenerative disease. Radiographs were considered normal in three. Two of the patients with initially normal radiographs subsequently showed loss of cortices on follow-up studies within 2 weeks. All of the patients had increased activity on scintigrams (five were obtained with technetium-99m methylene diphosphonate; one was with gallium). The findings suggest that scintigraphy is useful in the detection of pyogenic sacroiliitis in IV drug abusers when plain films are normal.

Adult↗
PubMed2003

Pregnancy-associated pyogenic sacroiliitis: case report and review.

BACKGROUND: Pyogenic sacroiliitis occurs infrequently during the peripartum period. CASE: A case at our institution and a review of the literature were analyzed. A total of 15 cases were discovered. The onset of illness was during pregnancy (40% of cases), within 3 weeks postpartum (40%) or post-abortion (20%), and the presentation was usually acute (< 7 days in 67% of cases). Frequent manifestations included localized pain in the hips or buttock, sacroiliac joint tenderness and fever. Computed tomography or magnetic resonance imaging revealed joint involvement in all cases tested. Microbiology was confirmed by blood (40%) or joint aspirate (75%), and most patients were treated with antibiotics. Surgical intervention took place in five cases. Preterm labor was reported in only one case. All patients responded well to therapy without locomotive disability, and persistent pain was uncommon. CONCLUSION: Septic sacroiliitis should be considered in peripartum patients who present with fever and severe localized pain. Medical management is usually curative, and without an adverse effect on pregnancy.

Adult↗
PubMed1988

Alpha 1-antitrypsin phenotypes in acute anterior uveitis.

The alpha 1-antitrypsin phenotype PiMZ has been reported to have a higher than normal incidence in patients with acute anterior uveitis, indicating an important role in the immunogenetics of this condition. We have determined the incidence of this phenotype in 72 patients with acute anterior uveitis. It was found to occur in four patients (5.6% of the total), with the highest incidence (3/34 or 8.8%, p less than 0.001) in patients negative for HLA B27 and without sacroiliac joint disease. The incidence in HLA B27 positive patients was normal. No correlation was found with the severity, bilaterality, or recurrence of uveitis. Although this increased incidence is statistically significant in comparison with the normal population incidence of 2.6%, its direct clinical significance is questionable; the most likely explanation for it includes possible linkage with other immunoregulatory genes. We also found a lower than expected incidence of the phenotype PiMS, and discuss the relevance of this finding.

Adolescent↗
PubMed1998

[Magnetic resonance imaging of seronegative sacroiliitis].

INTRODUCTION: The inflammatory involvement of the sacroiliac joint is frequent during seronegative spondylarthritis. The clinical diagnosis of sacroiliitis may be very difficult, especially in the early stage, because joint motion cannot be assessed directly and the clinical picture is very similar to that of lumbar pain. Conventional radiography is negative as long as the structural change in the joint is limited to the synovial membrane and the cartilage (early stage). Computed Tomography (CT) also has many drawbacks, and thus the changes can be shown only when chondritis and enthesitis have already damaged the bone. The disease onset is usually preceded by a long latency; early diagnosis is needed for a proper and timely treatment, which can be made only with a highly sensitive and specific technique. We investigated the diagnostic accuracy of MRI in the early detection of sacroiliitis during seronegative spondylarthritis. MATERIAL AND METHODS: Forty patients with suspected sacroiliitis and negative radiographic findings were submitted to MRI; thirty-seven of them were HLA B27 positive. MRI was performed with a .5 T superconducting unit; T1-weighted SE, T2-weighted FSE, T2* GE, and STIR images were acquired on the oblique coronal plane parallel to the anterior sacrum. Ten asymptomatic volunteers were also examined as a control group. RESULTS: An irregular sacral border and marrow changes at the insertion of the sacroiliac ligaments were seen in 3/10 asymptomatic volunteers. MRI was negative in 7/40 patients, while the synovial compartment was replaced by some tissue with low signal intensity of T1 and high signal on T2 in the other 33 patients; this finding was referred to synovial pannus. Persisting low-signal foci were seen in the synovial compartment in 16/33 patients, which were referred to spared cartilage. High-signal regions were depicted at the bone periphery in 9/33 patients, which areas were consistent with bone erosion; the subchondral bone was markedly hypointense in 5 of these patients, indicating sclerosis. Finally, diffuse high signal intensity was found in the bone marrow in 3/33 patients and referred to infectious sacroiliitis. CONCLUSIONS: MRI appears the method of choice for the early detection of seronegative sacroiliitis because it can show the early changes in cartilage and subchondral bone, filling the gap between the onset of symptoms and radiographic evidence. Moreover, MRI uses no ionizing radiations and makes therefore a precious tool for the diagnosis and follow-up of young patients, hopefully decreasing the use of CT which however provides better detailing of bone and bone degeneration.

Arthritis↗
PubMed1993

[Severe backache in clinically inactive ulcerative colitis].

A 22-year-old man with a history of ulcerative colitis complained of progressive lower back pain that had persisted for more than one year and which finally confined him to bed. X-ray examination revealed sclerosis of the right sacroiliac joint, and of the 6th lumbar vertebra. An NMR examination revealed a diffuse signal loss in the region of the 6th lumbar vertebra. On account of the progressive increase in liver transaminases in the serum, an ERCP was carried out, which confirmed the suspected primary sclerosing cholangitis (PSC). Severe axial arthritis and PSC with underlying clinically inactive ulcerative colitis was diagnosed, and treatment with salazosulfapyridine and ursodeoxycholic acid initiated. This led to freedom from pain within a matter of weeks and an appreciable reduction in serum cholestasis parameters.

Adult↗
PubMed1988

Evaluation of patients with back pain of suspected inflammatory nature.

PURPOSE: Detection of early inflammatory back disease is often difficult. Certain clinical characteristics have been reported to increase the likelihood of its detection in referral patients, but the usefulness of these clinical characteristics has not been evaluated in an open population. In our study, we undertook to evaluate the value of the clinical history as a screening test for inflammatory back disease in a general population. PATIENTS AND METHODS: Twenty-three male patients with back pain of moderate duration and with clinical characteristics suggestive of inflammatory back disease were recruited by advertising and were studied by various means, including computed tomography (CT), scintigraphy, and radiography. RESULTS: One patient had radiographic sacroiliitis. Two had positive results for the B27 antigen, and another had positive results for the cross-reacting HLA antigen B7. Eight patients had abnormal scintiscans of the sacroiliac joints. Twenty-one of 23 patients and 20 of 23 control subjects had abnormalities that were detected by CT. Repeat plain radiographs of the pelvis done 36 months after enrollment into the study did not uncover further evidence of sacroiliitis. CONCLUSIONS: These results indicate plain radiographic evidence of sacroiliitis will often not develop in patients with historical features suggestive of inflammatory back disease even with long-term evaluation, thus vitiating the specificity of these historical findings in men with back pain of relatively brief duration.

Adult↗
PubMed1981

CT of sacroiliitis.

Sacroiliitis is often difficult to diagnose with certainty using conventional radiographs and radionuclide scanning. Computed tomography was used to study the sacroiliac joints in 20 consecutive patients clinically suspected of having sacroiliitis on initial evaluation. Of these 20 patients, 17 fulfilled conventional clinical criteria for sacroiliitis; computed tomography demonstrated changes of sacroiliitis in 12 of these 17 patients. CT revealed no changes of sacroiliitis in the three patients who failed to meet conventional clinical criteria for sacroiliitis. Conventional radiography demonstrated diagnostic changes of sacroiliitis in only five patients. Seven patients with CT changes of sacroiliitis had equivocal or negative conventional films. CT therefore seems superior to conventional radiography in detecting sacroiliitis.

Arthritis↗
PubMed1998

Acute brucella sacroiliitis: clinical features.

Although back pain is very common, the differential diagnosis may sometimes be very difficult. Both inflammation and infections of spinal or sacroiliac joints are examples of such causes. We report three cases of brucella sacroiliitis resembling acute low back pain or lumbar disc herniation. All patients had had a recent infection and were referred complaining of acute back pain with a suspicion of lumbar disc herniation. The complaints of all patients reduced dramatically after proper medication. Radiographs of all patients and bone scans of two patients revealed sacroiliitis. One of the patients was positive for HLA-B27; in the other two patients HLA-B27 could not be determined.

Acute Disease↗
PubMed1999

Sacroiliitis - it's not all B 27.

We describe an HLA-B27 positive patient in whom posttraumatic pyogenic sacroiliitis led to complete unilateral sacroiliac joint ankylosis in the absence of any signs indicative of HLA-B27 associated spondyloarthropathy. Sacroiliitis is the pathologic hallmark - and usually one of the earliest pathologic manifestations - of ankylosing spondylitis (AS). Bilateral sacroiliitis is typical for ankylosing spondylitis. The frequency of asymmetric sacroiliitis may be higher in other inflammatory disorders, e.g., reactive arthritis, Reiters syndrome, spondylitis associated with psoriasis, or inflammatory bowel disease. Most but not all of these disorders show an increased prevalence among individuals who have inherited the HLA-B27 gene. In the context of this case, we discuss the differential diagnosis of unilateral sacroiliitis.

Adult↗
PubMed1983

Computed tomography of the pelvis in patients with multiple injuries.

The extent of osseous pelvic injury in patients suffering multiple organ trauma is difficult to assess. However, accurate information is essential in order to determine an acceptable treatment regimen, either operative (external or internal fixation), or nonoperative (bed rest and early ambulation). Twenty consecutive patients were treated for pelvic fractures from January 1981 through February 1982. All patients had multiple organ injuries, (average = 3.5 organ systems per patient). Each patient had an A-P X-ray projection of the pelvis in the emergency department (E.D.) as a part of the initial evaluation. Three patients (15%) required immediate laparotomy for associated abdominal injuries. Six patients (30%) required prolonged ventilatory support for pulmonary injuries. Computed tomography (CT) of the pelvis was performed on all patients within 4 days of admission. In seven patients, CT examination confirmed the findings of the routine X-rays obtained in the E.D. In 13 patients the CT examination demonstrated significant additional fractures of the pelvis which were not initially demonstrated in the E.D. A consistent pattern of either sacral fracture or injury to the sacroiliac joint which was not appreciated on the initial E.D. X-rays was demonstrated in these 13 patients. Six patients underwent operative intervention, four with Hoffmann frames (external fixation), and two with reduction and internal fixation. CT examination of the pelvis provides a rapid and thorough evaluation which is extremely useful in demonstrating all the fractures of the pelvis on the single examination, thereby allowing the early determination of the best treatment plan for patients with such major injuries.

Accidents, Occupational↗
PubMed2005

A longitudinal study on an autoimmune murine model of ankylosing spondylitis.

BACKGROUND: Proteoglycan aggrecan (PG)-induced arthritis (PGIA) is the only systemic autoimmune murine model which affects the axial skeleton, but no studies have been performed characterising the progression of spine involvement. OBJECTIVES: To follow pathological events in experimental spondylitis, and underline its clinical, radiographic, and histological similarities to human ankylosing spondylitis (AS); and to determine whether the spondyloarthropathy is a shared phenomenon with PGIA, or an "independent" disease. METHODS: Arthritis/spondylitis susceptible BALB/c and resistant DBA/2 mice, and their F1 and F2 hybrids were immunised with cartilage PG, and radiographic and histological studies were performed before onset and weekly during the progression of spondylitis. RESULTS: About 70% of the PG immunised BALB/c mice develop spondyloarthropathy (proteoglycan-induced spondylitis (PGISp), and the progression of the disease is very similar to human AS. It begins with inflammation in the sacroiliac joints and with enthesitis, and then progresses upwards, affecting multiple intervertebral disks. In F2 hybrids of arthritis/spondylitis susceptible BALB/c and resistant DBA/2 mice the incidence of arthritis was 43.5%, whereas the incidence of spondylitis was >60%. Some arthritic F2 hybrid mice had no spondylitis, whereas others developed spondylitis in the absence of peripheral arthritis. CONCLUSIONS: The PGISp model provides a valuable tool for studying autoimmune reactions in spondylitis, and identifying genetic loci associated with spondyloarthropathy.

Animals↗