Are We Overcalling Sacroillitis on MRI? Differential diagnosis that every rheumatologist should know - Part II

Acta Reumatol Port. 2019 Jan-Mar;44(1):42-56.

Abstract

In the second part of this review article we will describe the imaging features of non- spondyloarthritis (SpA) pathologies that may mimic sacroiliitis on Magnetic Resonance Imaging (MRI), and that readers should be aware (part 2). Based on the established literature, there is currently an "overcall" of sacroiliitis on MRIs. In this setting, differential diagnoses and their imaging features come into play. In fact, non-SpA related sacroiliac joints (SIJs) pathologies are more commonly found than true sacroiliitis on MRI of the SIJs, even in patients with inflammatory type back pain. An imaging literature review, highlighting "easy-to-use" learning points regarding MRI interpretations in patients with suspected sacroiliitis and/or nonspecific lumbar back pain is presented. This two-part article aims to be a snapshot of the most common inflammatory versus non-inflammatory entities found on SIJs imaging studies in routine practice, while trying to keep this review article simple, educational and above all, practical.

Publication types

  • Review

MeSH terms

  • Acquired Hyperostosis Syndrome / diagnostic imaging
  • Adult
  • Bone Neoplasms / diagnostic imaging
  • Diagnosis, Differential
  • Diagnostic Errors
  • Female
  • Fractures, Stress / diagnostic imaging
  • Gout / diagnostic imaging
  • Humans
  • Hyperostosis, Diffuse Idiopathic Skeletal / diagnostic imaging
  • Hyperthyroidism / complications
  • Infections / diagnostic imaging
  • Low Back Pain / diagnostic imaging
  • Lumbar Vertebrae / diagnostic imaging
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Osteitis / diagnostic imaging
  • Osteitis Deformans / diagnostic imaging
  • Osteoarthritis / diagnostic imaging
  • Sacroiliac Joint / anatomy & histology
  • Sacroiliac Joint / diagnostic imaging*
  • Sacroiliitis / diagnostic imaging*
  • Sarcoidosis / diagnostic imaging
  • Spondylarthritis / diagnostic imaging*