Sacro-iliac joint arthrography in low back pain: feasibility of MRI guidance.
OBJECTIVE
Evaluation of the feasibility of MR-guidance in sacro-iliac joint arthrography in patients whose low back pain is suspected to arise from the sacro-iliac joint (SIJ).


METHODS
Twenty patients with low back pain underwent MR-guided sacro-iliac joint arthrography. Needles made from titanium (size 20 G, MDTech, USA) were used. For image guidance a 0.23T open-configuration C arm magnet (Proview, Marconi Medical Systems, USA) with special interventional hardware and software package (I-Path 200, Marconi Medical Systems) containing an MR compatible in-room console, large-screen (36") display, optical navigator and accompanying software with dedicated sequences was used. No other image guidance modalities were used.


RESULTS
MR-guided SIJ arthrography was successfully performed in all twenty patients without complications. The optimal imaging sequence both for preoperative and intraoperative images was 3D-Gradient Echo sequence. The dispersal of the injected saline and anaesthetic could be determined inside the joint in all cases with heavily T2-weighted fast spin echo sequence. In the present study, 60% of the patients had significant reduction of pain after sacro-iliac joint arthrography and sacro-iliac joint was considered to be the source of patients low back pain in these patients.


CONCLUSIONS
The present study shows that MR guidance with open configuration low field scanner is an accurate guiding method for sacro-iliac joint arthrography.
Ojala
R
R
Department of Diagnostic and Interventional Radiology, University Hospital of Oulu, PL 22, 90221 Oulu, Suomi, Finland. risto.ojala@oulu.fi
Klemola
R
R
Karppinen
J
J
Sequeiros
R B
RB
Tervonen
O
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D001175:Arthrography / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012446:Sacroiliac Joint / Q000473:pathology / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*