Elgafy H, Semaan H B, Ebraheim N A, Coombs R J
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo 43614-5807, USA.
Clin Orthop Relat Res. 2001 Jan(382):112-8. doi: 10.1097/00003086-200101000-00017.
This retrospective study evaluated the diagnostic value of computed tomography in patients with sacroiliac pain. Computed tomography scans of the sacroiliac joints of 62 patients with sacroiliac joint pain were reviewed. The criteria to include the patient in the current study were pain relief after a local injection in the sacroiliac joint under computed tomography guidance, a physical examination consistent with a sacroiliac origin of the pain, and negative magnetic resonance imaging of the lumbar spine. A control group consisted of 50 patients of matched age who had computed tomography scans of the pelvis for a reason other than pelvic or back pain. Computed tomography scans showed one or more findings in 57.5% and 31% of the sacroiliac joints in the symptomatic and the control groups, respectively. The computed tomography scans were negative in 37 (42.5%) symptomatic sacroiliac joints with a positive sacroiliac joint injection test. The sensitivity of computed tomography was 57.5 % and its specificity was 69%. The finding of the current study suggests limited diagnostic value of computed tomography in sacroiliac joint disease because of its low sensitivity and specificity. With clinical suspicion of a sacroiliac origin of pain, intraarticular injection is currently the only means to confirm that diagnosis.
这项回顾性研究评估了计算机断层扫描在骶髂关节疼痛患者中的诊断价值。回顾了62例骶髂关节疼痛患者的骶髂关节计算机断层扫描图像。纳入本研究的患者标准为在计算机断层扫描引导下骶髂关节局部注射后疼痛缓解、体格检查结果与疼痛源自骶髂关节相符以及腰椎磁共振成像结果为阴性。对照组由50名年龄匹配的患者组成,他们因骨盆或背部疼痛以外的原因进行了骨盆计算机断层扫描。计算机断层扫描显示,症状组和对照组的骶髂关节分别有57.5%和31%出现了一项或多项异常表现。在骶髂关节注射试验呈阳性的37个(42.5%)有症状的骶髂关节中,计算机断层扫描结果为阴性。计算机断层扫描的敏感性为57.5%,特异性为69%。本研究结果表明,由于计算机断层扫描的敏感性和特异性较低,其在骶髂关节疾病中的诊断价值有限。当临床上怀疑疼痛源自骶髂关节时,关节内注射目前是确诊的唯一方法。