Background The diagnosis of sacroiliitis is usually performed on X-rays but frequently this method of imaging can be normal and the diagnosis of sacroiliitis can be missed, particularly in patients B27 negative.
Objectives To determine which signs are the most accurate in the diagnosis of sacroiliitis with MRI.
Methods 15 patients with inflammatory low back pain have been referred to us.
The patients were divided in 2 groups.
Group 1: 8 patients with normal X-rays; 6 were B27 negative and 2 were B27 positive: MRI showed abnormalities related to sacroiliitis.
Group 2: 7 patients with normal X-rays; 6 were B27 positive and 1 was negative: MRI showed inflammatory signs.
Results The examination showed bone narrow oedema, bone erosions, ligamentous contrast enhancement and fluid in the joint space.
Conclusion This study confirms the excellent positive predictive value of MRI for an early diagnosis of active sacroiliitis, especially in B27 negative patients and/or with normal X-rays.
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