title: Evaluation of acute and chronic MRI features of sacroiliitis in asymptomatic primary hyperparathyroid patients.
abstract: Asymptomatic primary hyperparathyroidism (PHPT) is characterized with autonomous overproduction of parathyroid hormone without signs or symptoms associated with hyperparathyroidism. Before symptoms become obvious, PHPT may affect structures like sacroiliac joints, which consist of bone. So, in the asymptomatic PHPT patients, structural and inflammatory changes in sacroiliac joints may lead to confusion during diagnosis workup of axial spondyloarthropathy. In this study, we evaluated active and chronic sacroiliac magnetic resonance imaging (MRI) changes relevant to sacroiliitis in the patients with asymptomatic PHPT and interpreted bone marrow edema within the scope of Assessment of SpondyloArthritis International Society-Outcome Measures in Rheumatology Clinical Trials (ASAS-OMERACT) criteria. Forty-nine patients with asymptomatic PHPT, 26 patients with newly diagnosed axial spondyloarthropathy (SpA), and 37 healthy controls were enrolled. All subjects were evaluated by sacroiliac MRI for four active (bone marrow edema, enthesitis, capsulitis, and synovitis) and four chronic (subchondral sclerosis, subchondral/periarticular erosions, periarticular fat deposition, and bony bridges/ankylosis) lesions relevant to sacroiliitis. Bone marrow edema compatible with ASAS-OMERACT active sacroiliitis criteria in sacroiliac MRI was fulfilled by 16.3 % (8/49) of the asymptomatic PHPT patients which was similar with controls but statistically lower than axial SpA. Moreover, asymptomatic PHPT patients and controls were similar for other chronic or active MRI findings. Also, we detected lower frequency of all other MRI findings, except enthesis, in asymptomatic PHPT patients according to axial SpA. Acute inflammatory including bone marrow edema fulfilling ASAS-OMERACT active sacroiliitis criteria and chronic structural sacroiliac lesions relevant to sacroiliitis in MRI were detected in asymptomatic PHPT similar frequency with controls but as expected, lower than axial SpA. But, these findings could not be attributed to excessive secretion of parathyroid hormone.
authors.affiliation: Department of Rheumatology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Kartal, 34890, Istanbul, Turkey. engintez@yahoo.com.
authors.forename: Mehmet Engin
authors.initials: ME
authors.lastname: Tezcan
authors.affiliation: Department of Endocrinology and Metabolism, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
authors.forename: Sule
authors.initials: S
authors.lastname: Temizkan
authors.affiliation: Department of Radiology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
authors.forename: Safiye Tokgoz
authors.initials: ST
authors.lastname: Ozal
authors.affiliation: Department of Family Medicine and Diabetes, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Gul
authors.affiliation: Department of Endocrinology and Metabolism, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
authors.forename: Kadriye
authors.initials: K
authors.lastname: Aydin
authors.affiliation: Department of Endocrinology and Metabolism, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
authors.forename: Aysenur
authors.initials: A
authors.lastname: Ozderya
authors.affiliation: Department of Family Medicine and Diabetes, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sargin
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging*; D058566:Sacroiliitis / Q000000981:diagnostic imaging*
keywords: Magnetic resonance imaging; Primary hyperparathyroidism; Sacroiliac joint; Sacroiliitis