Current Role of Conventional Radiography of Sacroiliac Joints in Adults and Juveniles with Suspected Axial Spondyloarthritis: Opinion from the ESSR Arthritis and Pediatric Subcommittees

Iwona Sudoł-Szopińska; Nele Herregods; Anna Zejden; Lennart Jans; Chiara Giraudo; Mikael Boesen; Fabio Becce; Alberto Bazzocchi; Paolo Simoni; Maria Pilar Aparisi Gómez; Jacob Jaremko; Mario Maas; James Teh; Kay-Geert Hermann; Flavia Menegotto; Amanda Isaac; Monique Reijnierse; Amit Shah; Winston Rennie; Anne Grethe Jurik

doi:10.1055/s-0043-1772169

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2023; 27(05): 588-595
DOI: 10.1055/s-0043-1772169

Review Article

Current Role of Conventional Radiography of Sacroiliac Joints in Adults and Juveniles with Suspected Axial Spondyloarthritis: Opinion from the ESSR Arthritis and Pediatric Subcommittees

Authors

Iwona Sudoł-Szopińska

¹Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
Nele Herregods

²Department of Radiology and Nuclear Medicine - Division of Pediatric Radiology, Princess Elisabeth Children's Hospital/Ghent University Hospital, Ghent, Belgium
Anna Zejden

³Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
Lennart Jans

⁴Department of Radiology, Ghent University Hospital, Ghent, Belgium
Chiara Giraudo

⁵Department of Medicine – DIMED, University of Padova, Padova, Italy
Mikael Boesen

⁶Department of Radiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark

⁷Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Fabio Becce

⁸Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
Alberto Bazzocchi

⁹Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
Paolo Simoni

¹⁰Pediatric Imaging Department, Reine Fabiola Children's University Hospital, ULB, Brussels, Belgium
Maria Pilar Aparisi Gómez

¹¹Department of Radiology, Auckland City Hospital, Auckland District Health Board, Grafton, Auckland, New Zealand

¹²Department of Radiology, IMSKE, Valencia, Spain
Jacob Jaremko

¹³Department of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta Hospital, Edmonton, AB, Canada
Mario Maas

¹⁴Department of Radiology & Nuclear Medicine, Amsterdam UMC, location AMC – University of Amsterdam, Amsterdam, Netherlands
James Teh

¹⁵Radiology Department, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
Kay-Geert Hermann

¹⁶Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
Flavia Menegotto

¹⁷Bristol Royal Hospital for Children Paediatric Radiology Department, University Hospitals Bristol and Weston NHS Foundation Trust (UHBW), Bristol, United Kingdom
Amanda Isaac

¹⁸School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
Monique Reijnierse

¹⁹Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
Amit Shah

²⁰Department of Radiology, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, United Kingdom
Winston Rennie

²¹Department of Radiology, University Hospitals of Leicester NHS Trust, Loughborough University, Loughborough, United Kingdom
Anne Grethe Jurik

³Department of Radiology, Aarhus University Hospital, Aarhus, Denmark

Abstract

This opinion article by the European Society of Musculoskeletal Radiology Arthritis and Pediatric Subcommittees discusses the current use of conventional radiography (CR) of the sacroiliac joints in adults and juveniles with suspected axial spondyloarthritis (axSpA). The strengths and limitations of CR compared with magnetic resonance imaging (MRI) and computed tomography (CT) are presented.

Based on the current literature and expert opinions, the subcommittees recognize the superior sensitivity of MRI to detect early sacroiliitis. In adults, supplementary pelvic radiography, low-dose CT, or synthetic CT may be needed to evaluate differential diagnoses. CR remains the method of choice to detect structural changes in patients with suspected late-stage axSpA or established disease and in patients with suspected concomitant hip or pubic symphysis involvement. In children, MRI is the imaging modality of choice because it can detect active as well as structural changes and is radiation free.

Keywords

radiographs - axial spondyloarthritis - spondyloarthropathy - sacroiliitis

Full Text

References

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