Radial MR Screen of the Sacroiliac Joints in the Lumbar Spine of Patients with Chronic Lower Back Pain

Abstract

Objective: Magnetic resonance imaging (MRI) can reliably detect inflammation and structural changes in sacroiliac joints (SIJs) in patients with lower back pain (LBP). How -ever, patients with LBP are usually referred for MRI of the lower back (e.g. lumbar spine LS), and imaging of the SIJs is rarely requested for these patients. The aim of this work is to use radial MRI as an additional screening technique for SIJ pathology presenting in lumbar spine patients with chronic LBP. Materials and methods: One hundred one (54 males/47 fe males) patients complaining primarily of LBP were screened using a 1.5-T MRI system. MRI scanning was performed using sagittal and axial T2-weighted sequences for the LS (12 min) and the radial T2-weighted-fat saturated sequence for the SIJs (1.20 min). Two radiologists specializing in musculoskeletal MRI individually evaluated the SIJ imag es for anatomical accuracy and pathology. Results: Almost all radial SIJ images (95%) were diagnostically acceptable for reporting; 73.3% showed LS pathology only, whereas 26.7% displayed a combination of LS and SIJ pathology. Secondary findings indicate a significant correlation with gender (p = 0.014), namely, females were more prone to SIJ disease than males. Conclusion: Radial images were used to detect the pres ence and size of the anatomical deformity in LBP patients. Patients with detected pathology were then recommended for further follow-up and full diagnostic examination.