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Magnetic resonance imaging findings of sacroiliitis in patients with psoriasis

Year 2013, Volume: 4 Issue: 2, 199 - 203, 01.06.2013
https://doi.org/10.5799/ahinjs.01.2013.02.0265

Abstract

Objectives: The aim of this study was to determine the frequency and characteristic magnetic resonance (MR) imaging features of sacroiliitis in patients with psoriasis disease. Methods: A total of 68 patients who diagnosed with pso­riasis in Dermatology department of our hospital between February-2012 and February-2013 were included to our study. All patients were underwent bilateral sacroiliac MR. MR study were performed with the sequences of the coro­nal T1 weighted turbo spin-echo, T2 weighted and STIR images using a 1,5-T MR device for all patients. Changes in the subchondral bone were classified according to MR signal features. Results: Of these patients, 37 (54.4 %) were male and 31 (45.6 %) were female. The mean age was 32.3±7.8 years, ranging from 16 to 60 years. Mean disease dura­tion was 12.4±8.6 years (2-24 years). While MR imag­ing findings were normal in 52 (76,5%) patients, signal changes consisted with sacroiliitis were observed in 16 (23.5%) patients. One or more MR lesion consisted with sacroiliitis were observed in a total of 22 sacroiliac joint of 16 patients. The signal abnormalities detected by MR imaging were as follows, Type-1 changes in 6 (27.3%) joints, Type-2 changes in 8 (36.4%) joints, Type-3 chang­es in 10 (45.5%) joints, erosions in 9 (40.9%) joints, nar­rowing the joints space in 6 (27.3%) joints and ankylosis in 5 (22.7%) joints. Conclusion: Sacroiliitis in psoriatic patients is an impor­tant clinical problem. MR imaging is a useful diagnostic modality in the diagnosis of psoriatic sacroiliitis which can demonstrate detailed anatomy of the sacroiliac joint and the changes of sacroiliitis without radiation exposure. J Clin Exp Invest 2013; 4 (2): 199-203

References

  • Gelfand JM, Gladman DD, Mease PJ, et al. Epidemiol- ogy of psoriatic arthritis in the population of the United States. J Am Acad Dermatol 2005;53:573.
  • Shbeeb M, Uramoto KM, Gibson LE, et al. The epide- miology of psoriatic arthritis in Olmsted County, Min- nesota, USA, 1982-1991. J Rheumatol 2000;27:1247- 1250.
  • Tuncer S. Psoriatic Arthritis Türkiye Klinikleri J Int Med Sci 2005;1:32-38.
  • Camp RDR. Psoriasis. In: Champion RH, Burton JL, Burns DA, Breathnach SM, eds. Textbook of Derma- tology, Sixth edition. Oxford, Blackwell Science Publ., 1998:1589-1649.
  • Ahlström H, Felteius N, Nyman R, Hallgren R. Magnetic resonance imaging of sacroiliac joint inflammation. Ar- thritis Rheum 1990;33:1763-1769.
  • Muche B, Bollow M, Francois RJ, et al. Anatomic struc- tures involved in early- and late-stage sacroiliitis in spon-dylarthritis: a detailed analysis by contrast-en- hanced magnetic resonance imaging. Arthritis Rheum 2003;48:1374-1384.
  • Dougados M, Van der Linden S, Juhlin R, et al. The Eu- ropean Spondyloarthropathy Study Group preliminary criteria for the classification of spondyloarthropathy. Arthritis Rheum 1991;34:1218-1227.
  • Helliwell PS, Taylor WJ. Classification and diagnostic criteria for psoriatic arthritis. Ann Rheum Dis 2005, Suppl II:ii3-ii7.
  • Gladman DD. Psoriatic Arthritis. Rheum. Dis Clin North Am 1998;24:829-844.
  • Marsal S, Armadans-Gil L, Martinez M, et al. Clini- cal, radiographic and HLA assosiations as markers for different patterns of psoriatic arthritis. Rheumatology 1999;38:332-337.
  • Braun J, Bollow M, Seper J. Radiology and pathology of the spondyloarthropathies. Rheum Dis Clin N Am 1998;24:697-735.
  • Murphy MD, Wetzel LH, Brable JM, et al. Sacroiliitis: MR imaging findings. Radiology 1991;180:239-244.
  • Braun J, Bollow M, Seper J. Radiology and pathology of the spondyloarthropathies. Rheum Dis Clin N Am 1998;24:697-735.
  • Yu W, Feng F, Dion E, et al. Comparison of radiogra- phy, computed tomography and magnetic resonance imag-ing in the detection of sacroiliitis accompanying ankylosing spondylitis. Skeletal Radiol 1998;27:311- 320.
  • Blum U, Buitrago-Tellez C, Mudinger A, et al. Mag- netic resonance imaging (MRI) for detection of active sacroiliitis: a prospective study comparing conven- tional radiography, sintigraphy and contrast-enhanced MRI. J Rheumatol 1996;23:2107-2115.
  • Battafarano DF, West SG, Rak KM, et al. Comparision of bone scan, computed tomography and magnetic resonance imaging in the diagnosis of active sacroili- itis. Semin Arthritis Rheum 1993;23:161-176.
  • Ahlström H, Felteius N, Nyman R, Hallgren R. Mag- netic resonance imaging of sacroiliac joint inflamma- tion. Arthritis Rheum 1990;33:1763-1769.
  • Docherty P, Mitchell MJ, MacMillan L, et al. Magnetic resonance imaging in the detection of sacroiliitis. J Rheumatol 1992;19:393-401.
  • Wittram C, Whitehouse CH. Normal variation in the magnetic resonance imaging appearances of the sac- roiliac joints: pitfalls in the diagnosis of sacroiliitis. Clin Radiol 1995;50:371-376.
  • Ricci C, Cova M, Kang YS, et al. Normal age related patterns of cellular and fatty bone marrow distribution in the axial skeleton: MR imaging study. Radiology 1990;177:83-88.
  • Dawson KL, Moore SG, Rowland CM. Age related marrow changes in the pelvis: MR and anatomical findings. Radiology 1992;183:47-51.

Psöriazisli hastalarda sakroileitin manyetik rezonans görüntüleme bulguları

Year 2013, Volume: 4 Issue: 2, 199 - 203, 01.06.2013
https://doi.org/10.5799/ahinjs.01.2013.02.0265

Abstract

Amaç: Bu çalışmanın amacı, psöriazisli hastalardaki
sakroileit sıklığını ve sakroileite ait karakteristik manyetik
rezonans (MR) görüntüleme bulgularını belirlemektir.
Yöntemler: Çalışmamıza hastanemiz Dermatoloji polikliniğinde,
Şubat 2012-Şubat 2013 tarihleri arasında klinik
ve histopatolojik olarak psöriazis tanısı konulan toplam 68
hasta dâhil edildi. Tüm hastalara bilateral sakroiliak MR
inceleme yapıldı. MR görüntüleme, 1,5 T sistemde, koronal
planda T1-ağırlıklı turbo spin-echo, T2-ağırlıklı ve
yağ-baskılı short tau inversion recovery (STIR) sekansları
ile uygulandı. Subkondral kemikteki değişiklikler MR sinyal
özelliklerine göre sınıflandırıldı.
Bulgular: Çalışmaya dâhil edilen hastaların 37’si (%54,4)
erkek, 31’i (% 45,6) kadın idi. Yaşları 16-60 yıl arasında
değişen hastaların yaş ortalaması 32,3±7,8 yıl olarak
bulundu. Hastaların ortalama hastalık süresi 12,4±8,6
yıl (dağılım 2-24 yıl) idi. Toplam 68 psöriazis hastasının
52’sinde (%76,5) sakroileit lehine herhangi bir bulgu saptanmazken,
16 hastada (%23,5) sakroileit ile uyumlu sinyal
değişiklikleri izlendi. Sakroileit saptanan 16 hastaya
ait toplam 22 sakroiliak eklemde bir ya da birden çok radyolojik
lezyonu saptadık. Manyetik rezonans incelemedeki
patolojik bulgulara göre sınıflandırıldığında 6 (%27,3)
eklemde Tip-1, 8 (%36,4) eklemde Tip-2, 10 (%45,5) eklemde
Tip-3 değişiklik bulguları, 9 (%40,9) eklemde erezyon,
6 (%27,3) eklemde eklem mesafesinde daralma ve 5
(%22,7) eklemde ankiloz bulguları izlendi.
Sonuç: Psöriazisli hastalarda sakroileit önemli bir problem
teşkil etmektedir. MR görüntüleme psöriazisli hastalardaki
sakroileit tanısında, sakroiliak eklem anatomisini
ve sakroileit lezyonlarını ayrıntılı olarak gösterebilen ve
radyasyon maruziyeti olmayan non-invaziv yararlı bir görüntüleme yöntemidir

References

  • Gelfand JM, Gladman DD, Mease PJ, et al. Epidemiol- ogy of psoriatic arthritis in the population of the United States. J Am Acad Dermatol 2005;53:573.
  • Shbeeb M, Uramoto KM, Gibson LE, et al. The epide- miology of psoriatic arthritis in Olmsted County, Min- nesota, USA, 1982-1991. J Rheumatol 2000;27:1247- 1250.
  • Tuncer S. Psoriatic Arthritis Türkiye Klinikleri J Int Med Sci 2005;1:32-38.
  • Camp RDR. Psoriasis. In: Champion RH, Burton JL, Burns DA, Breathnach SM, eds. Textbook of Derma- tology, Sixth edition. Oxford, Blackwell Science Publ., 1998:1589-1649.
  • Ahlström H, Felteius N, Nyman R, Hallgren R. Magnetic resonance imaging of sacroiliac joint inflammation. Ar- thritis Rheum 1990;33:1763-1769.
  • Muche B, Bollow M, Francois RJ, et al. Anatomic struc- tures involved in early- and late-stage sacroiliitis in spon-dylarthritis: a detailed analysis by contrast-en- hanced magnetic resonance imaging. Arthritis Rheum 2003;48:1374-1384.
  • Dougados M, Van der Linden S, Juhlin R, et al. The Eu- ropean Spondyloarthropathy Study Group preliminary criteria for the classification of spondyloarthropathy. Arthritis Rheum 1991;34:1218-1227.
  • Helliwell PS, Taylor WJ. Classification and diagnostic criteria for psoriatic arthritis. Ann Rheum Dis 2005, Suppl II:ii3-ii7.
  • Gladman DD. Psoriatic Arthritis. Rheum. Dis Clin North Am 1998;24:829-844.
  • Marsal S, Armadans-Gil L, Martinez M, et al. Clini- cal, radiographic and HLA assosiations as markers for different patterns of psoriatic arthritis. Rheumatology 1999;38:332-337.
  • Braun J, Bollow M, Seper J. Radiology and pathology of the spondyloarthropathies. Rheum Dis Clin N Am 1998;24:697-735.
  • Murphy MD, Wetzel LH, Brable JM, et al. Sacroiliitis: MR imaging findings. Radiology 1991;180:239-244.
  • Braun J, Bollow M, Seper J. Radiology and pathology of the spondyloarthropathies. Rheum Dis Clin N Am 1998;24:697-735.
  • Yu W, Feng F, Dion E, et al. Comparison of radiogra- phy, computed tomography and magnetic resonance imag-ing in the detection of sacroiliitis accompanying ankylosing spondylitis. Skeletal Radiol 1998;27:311- 320.
  • Blum U, Buitrago-Tellez C, Mudinger A, et al. Mag- netic resonance imaging (MRI) for detection of active sacroiliitis: a prospective study comparing conven- tional radiography, sintigraphy and contrast-enhanced MRI. J Rheumatol 1996;23:2107-2115.
  • Battafarano DF, West SG, Rak KM, et al. Comparision of bone scan, computed tomography and magnetic resonance imaging in the diagnosis of active sacroili- itis. Semin Arthritis Rheum 1993;23:161-176.
  • Ahlström H, Felteius N, Nyman R, Hallgren R. Mag- netic resonance imaging of sacroiliac joint inflamma- tion. Arthritis Rheum 1990;33:1763-1769.
  • Docherty P, Mitchell MJ, MacMillan L, et al. Magnetic resonance imaging in the detection of sacroiliitis. J Rheumatol 1992;19:393-401.
  • Wittram C, Whitehouse CH. Normal variation in the magnetic resonance imaging appearances of the sac- roiliac joints: pitfalls in the diagnosis of sacroiliitis. Clin Radiol 1995;50:371-376.
  • Ricci C, Cova M, Kang YS, et al. Normal age related patterns of cellular and fatty bone marrow distribution in the axial skeleton: MR imaging study. Radiology 1990;177:83-88.
  • Dawson KL, Moore SG, Rowland CM. Age related marrow changes in the pelvis: MR and anatomical findings. Radiology 1992;183:47-51.
There are 21 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Mehmet Fatih İnci This is me

Rahime İnci This is me

Publication Date June 1, 2013
Published in Issue Year 2013 Volume: 4 Issue: 2

Cite

APA İnci, M. F., & İnci, R. (2013). Psöriazisli hastalarda sakroileitin manyetik rezonans görüntüleme bulguları. Journal of Clinical and Experimental Investigations, 4(2), 199-203. https://doi.org/10.5799/ahinjs.01.2013.02.0265
AMA İnci MF, İnci R. Psöriazisli hastalarda sakroileitin manyetik rezonans görüntüleme bulguları. J Clin Exp Invest. June 2013;4(2):199-203. doi:10.5799/ahinjs.01.2013.02.0265
Chicago İnci, Mehmet Fatih, and Rahime İnci. “Psöriazisli Hastalarda Sakroileitin Manyetik Rezonans görüntüleme Bulguları”. Journal of Clinical and Experimental Investigations 4, no. 2 (June 2013): 199-203. https://doi.org/10.5799/ahinjs.01.2013.02.0265.
EndNote İnci MF, İnci R (June 1, 2013) Psöriazisli hastalarda sakroileitin manyetik rezonans görüntüleme bulguları. Journal of Clinical and Experimental Investigations 4 2 199–203.
IEEE M. F. İnci and R. İnci, “Psöriazisli hastalarda sakroileitin manyetik rezonans görüntüleme bulguları”, J Clin Exp Invest, vol. 4, no. 2, pp. 199–203, 2013, doi: 10.5799/ahinjs.01.2013.02.0265.
ISNAD İnci, Mehmet Fatih - İnci, Rahime. “Psöriazisli Hastalarda Sakroileitin Manyetik Rezonans görüntüleme Bulguları”. Journal of Clinical and Experimental Investigations 4/2 (June 2013), 199-203. https://doi.org/10.5799/ahinjs.01.2013.02.0265.
JAMA İnci MF, İnci R. Psöriazisli hastalarda sakroileitin manyetik rezonans görüntüleme bulguları. J Clin Exp Invest. 2013;4:199–203.
MLA İnci, Mehmet Fatih and Rahime İnci. “Psöriazisli Hastalarda Sakroileitin Manyetik Rezonans görüntüleme Bulguları”. Journal of Clinical and Experimental Investigations, vol. 4, no. 2, 2013, pp. 199-03, doi:10.5799/ahinjs.01.2013.02.0265.
Vancouver İnci MF, İnci R. Psöriazisli hastalarda sakroileitin manyetik rezonans görüntüleme bulguları. J Clin Exp Invest. 2013;4(2):199-203.