Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 35, Entrance C, location C118/ reference point C109, 8200, Aarhus N, Denmark.
Department of Pathology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark.
Skeletal Radiol. 2020 Mar;49(3):453-460. doi: 10.1007/s00256-019-03305-x. Epub 2019 Sep 4.
To introduce and evaluate computed tomography (CT)-guided transarticular needle biopsy of the cartilaginous sacroiliac joint (SIJ) and to assess the biopsy results microscopically.
The new CT-guided transarticular biopsy of the SIJ was performed in a young corpse and ten patients, two males and eight females aged 18-81 years. All patients had abnormal findings by magnetic resonance imaging (MRI) of the SIJs, including bone marrow edema, related to different types of joint disorders. The biopsies were focused on areas with bone marrow edema. The quality of the specimens obtained, using two different types of biopsy needles, was assessed microscopically.
Biopsies containing cartilage, subchondral plate, and bone marrow from the iliac and sacral sides were obtained from the corpse and three patients and from the iliac bone only in two patients. In three patients, the biopsy needles could not penetrate the bone marrow to the joint facet due to pronounced subchondral sclerosis, but adequate marrow biopsies were obtained. Two biopsies were inadequate, one due to technical problems and one was crushed during preparation. Histological assessment of eight adequate specimens revealed inflammatory bone marrow changes, except in two specimens from females with pronounced sclerosis conforming to osteitis condensans ilii.
Transarticular SIJ biopsies are obtainable and can be directed towards areas with MRI abnormalities. They can be used to confirm inflammatory changes histologically. With the biopsy needles used, severe bone marrow sclerosis may hinder penetration to the cartilage, but bone marrow specimens can be obtained.
介绍和评估 CT 引导下经关节突软骨骶髂关节（SIJ）针活检，并评估活检的显微镜结果。
在年轻尸体和 10 名患者中进行了新的 CT 引导下经关节突 SIJ 活检，2 名男性和 8 名女性年龄为 18-81 岁。所有患者的 SIJ MRI 均有异常发现，包括骨髓水肿，与不同类型的关节疾病有关。活检针对骨髓水肿区域进行。使用两种不同类型的活检针评估获得的标本质量，并进行显微镜评估。
尸体和 3 名患者获得了包含髂骨和骶骨侧软骨、软骨下板和骨髓的活检标本，2 名患者仅获得了髂骨的活检标本。在 3 名患者中，由于明显的软骨下硬化，活检针无法穿透骨髓到达关节面，但获得了足够的骨髓活检标本。2 份活检标本不足，1 份因技术问题，1 份在准备过程中被压碎。对 8 份充足标本的组织学评估显示，除了两名女性的标本显示明显硬化符合髂骨骨化性骨炎外，其余标本均显示炎症性骨髓改变。
经关节突 SIJ 活检是可行的，可以针对 MRI 异常区域进行。它们可用于组织学上确认炎症变化。使用的活检针可能会因严重的骨髓硬化而妨碍穿透软骨，但可以获得骨髓标本。
