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Clinical Article
Sacroiliac joint MRI findings in SAPHO syndrome
XU Wen-rui  LI Chen  SHAO Xia-li  ZHAO Xue  ZHANG Wei-hong 

DOI:10.12015/issn.1674-8034.2017.06.008.


[Abstract] Objective: To retrospectively evaluate the MRI features of sacroiliac joint (SIJ) disorders in 13 SAPHO patients, thus increasing the awareness of SAPHO syndrome among clinicians and improving its diagnostic accuracy.Materials and Methods: 13 SAPHO patients with SIJ involvement (female: male, 9:4; mean±SD age, 45.9±8.9 years) who presented to Peking Union Medical College Hospital between November 2014 and August 2015 were enrolled. MR images of the SIJs were evaluated.Results: In our study, 11 SAPHO patients were involved with SIJ disorders bilaterally and 2 unilaterally. Therefore, a total of 24 SIJs were affected. Among the involved 24 SIJs, lesions in 16 SIJs predominantly affected the sacrum, and lesions in 20 SIJs involved both the synovial proportion and ligamentous proportion. Several abnormal MRI signal intensities in the bone adjacent to SIJs were detected, including bone marrow edema(16/24), fatty deposition(24/24), bony erosion(18/24) and sclerosis (19/24). Joint space widening was present in 8.3%(2/24) of SIJs, joint space narrowing in 16.7%(4/24) and articular ankylosis in 20.8%(5/24). Articular effusions were observed in 25%(6/24) of SIJs. Edema in the surrounding soft tissue was detected in 8.3%(2/24) of SIJs.Conclusion: SIJs were more bilaterally involved in SAPHO patients, with predilection on the sacrum. Active lesions and chronic lesions usually coexist, with a lower prevalence of ankylosing. These MRI features could provide certain information of SAPHO syndrome. Consultation of skin lesions should be taken into consideration for a comprehensive evaluation and definite diagnosis.
[Keywords] SAPHO syndrome;Sacroiliac joint;Magnetic resonance imaging

XU Wen-rui Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China

LI Chen Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China

SHAO Xia-li Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China

ZHAO Xue Department of Radiology, Beijing Huairou Hospital, Beijing 101400, China

ZHANG Wei-hong* Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China

*Correspondence to: Zhang WH, E-mail: zhangweihong@pumch.cn

Conflicts of interest   None.

Received  2017-03-14
Accepted  2017-04-19
DOI: 10.12015/issn.1674-8034.2017.06.008
DOI:10.12015/issn.1674-8034.2017.06.008.

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