Bäcklund J, Clewett Dahl E, Skorpil M
Department of Radiology, Danderyd's Hospital, Stockholm, Sweden.
Department of Radiology, St Göran's Hospital, Stockholm, Sweden.
Clin Radiol. 2017 Aug;72(8):693.e9-693.e13. doi: 10.1016/j.crad.2017.03.006. Epub 2017 Apr 25.
To assess the value of computed tomography (CT) in the diagnosis of symptomatic sacroiliac (SI) joint degeneration.
CT images from 123 patients with clinically diagnosed SI joint pain were compared to age- and gender-matched controls without chronic back pain or previous back surgery. Degeneration was graded assessing joint space narrowing, osteophytes, subchondral sclerosis, cysts, and vacuum phenomena.
The mean total score for the patients was 9.6 and for the controls 9.7 (p=0.77). A subgroup analysis of the mean score for the SI joints that were subjected to surgery was 4.3, compared to 4.8 in the conservatively treated SI joints in the patient group (p=0.23) and 4.8 for all SI joints in the control group (p=0.25). For patients with unilateral left-sided pain (n=40), the mean score for the left side was 5.2 and for the right side 4.9 (p=0.49). For patients with right-sided pain (n=41), the mean score for the right side was 4.8 and the left side 4.7 (p=0.55).
The prevalence of SI joint degeneration on CT is equal in symptomatic and non-symptomatic individuals. This study indicates that the value of CT is limited, but further studies are needed to establish if CT has a place in diagnosing SI joint degeneration.
评估计算机断层扫描（CT）在诊断有症状的骶髂关节（SI）退变中的价值。
将123例临床诊断为骶髂关节疼痛患者的CT图像与年龄和性别匹配、无慢性背痛或既往无背部手术史的对照组进行比较。通过评估关节间隙变窄、骨赘、软骨下硬化、囊肿和真空现象对退变进行分级。
患者的平均总分是9.6，对照组为9.7（p = 0.77）。接受手术的骶髂关节平均得分亚组分析显示为4.3，而患者组中接受保守治疗的骶髂关节平均得分为4.8（p = 0.23），对照组所有骶髂关节平均得分为4.8（p = 0.25）。对于单侧左侧疼痛患者（n = 40），左侧平均得分为5.2，右侧为4.9（p = 0.49）。对于右侧疼痛患者（n = 41），右侧平均得分为4.8，左侧为4.7（p = 0.55）。
有症状和无症状个体CT上骶髂关节退变的患病率相同。本研究表明CT的价值有限，但需要进一步研究以确定CT在诊断骶髂关节退变中是否有一席之地。
