Early sacroiliitis in patients with spondyloarthropathy: evaluation with dynamic gadolinium-enhanced MR imaging.
OBJECTIVE
To investigate the diagnostic value of gadolinium-enhanced magnetic resonance (MR) imaging in the detection of early sacroiliitis.


METHODS
Of 125 patients with back pain, 72 had inflammatory back pain and had a diagnosis of spondylarthropathy; the other 53 patients had other mostly mechanical causes of back pain and served as the control group. The 72 patients with spondyloarthropathy were further subdivided into two groups according to established radiographic criteria for ankylosing spondylitis. While group 2 patients (n = 36) with a diagnosis of ankylosing spondylitis had definite radiographic changes in the sacroiliac joints, group 1 patients (n = 36) with undifferentiated spondylarthropathy had no such findings.


RESULTS
While no contrast enhancement was found in normal sacroiliac joints, significantly different degrees of enhancement (P < .05) related to the patients' degree of pain were clearly detected in both groups of patients with spondyloarthropathy. Contrary to the mostly normal findings with precontrast MR imaging and with radiography, dynamic MR imaging revealed small erosions (< 1 mm) in 47 (72%) of the 65 inflamed joints in group 1 and juxtaarticular osteitis in 53 (82%).


CONCLUSIONS
Contrast-enhanced MR imaging allows detection of sacroiliitis in early stages.
Bollow
M
M
Department of Radiology, Charité, Humboldt-University Berlin, Germany.
Braun
J
J
Hamm
B
B
Eggens
U
U
Schilling
A
A
König
H
H
Wolf
K J
KJ
D000293:Adolescent; D000328:Adult; D001168:Arthritis / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D012446:Sacroiliac Joint / Q000473:pathology*; D013167:Spondylitis, Ankylosing / Q000175:diagnosis
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA