Semin Musculoskelet Radiol 2008; 12(1): 072-082
DOI: 10.1055/s-2008-1067939
© Thieme Medical Publishers

Sacroiliac Joint Imaging

Michael J. Tuite1
  • 1Department of Radiology, Division of Musculoskeletal Radiology, University of Wisconsin Hospital and Medical School, Madison, Wisconsin
Further Information

Publication History

Publication Date:
01 April 2008 (online)

ABSTRACT

The sacroiliac (SI) joint has several unique anatomical features that make it one of the more challenging joints to image. The joint is difficult to profile well on radiographic views, and therefore the radiographic findings of sacroiliitis are often equivocal. Computed tomography images can usually show the findings of sacroiliitis and osteoarthritis earlier than radiographs. Magnetic resonance imaging performed with proper sequences is excellent for diagnosing even very early sacroiliitis and for following treatment response. The SI joint is often involved in patients with osteoarthritis or one of the inflammatory spondyloarthritides, most notably ankylosing spondylitis. Ankylosing spondylitis often presents with sacroiliitis, which appears as erosions, sclerosis, and joint space narrowing, eventually leading to ankylosis. Several disorders can cause sacroiliitis-like changes of the joint, including hyperparathyroidism and repetitive shear-stress injuries in athletes. The joint can become painful during pregnancy as it widens and develops increased motion, and some postpartum women develop iliac sclerosis adjacent to the joint termed osteitis condensans ilii. Another cause of SI joint pain is a disorder called sacroiliac joint dysfunction, which typically has few abnormal imaging findings. Patients with SI joint dysfunction, as well as sacroiliitis, often get relief from image-guided SI joint therapeutic injections.

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Michael J TuiteM.D. 

Department of Radiology, University of Wisconsin Hospital and Medical School

E3/311 600 Highland Ave., Madison, WI 53792

Email: mjtuite@wisc.edu

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