Kim Jin Kyem, Jung Jae Hyeop, Lee Hong Seon, Kim Dong Kyu
Department of Radiology, Armed Forces Capital Hospital, Seongnam, 13574, Korea.
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Korea.
Skeletal Radiol. 2023 Feb;52(2):199-204. doi: 10.1007/s00256-022-04177-4. Epub 2022 Sep 6.
The study aims to investigate the prevalence and neglected rate of sacroiliitis on lumbar spine computed tomography (CT) in patients with low back pain.
From January 2016 to December 2020, a total of 4827 patients (mean age: 35.4 ± 9.5 years) who underwent lumbar spine CT examinations were included in this retrospective study. The CT degree of sacroiliitis in all study population were retrospectively reviewed by two radiologists. The independent sample t-test was used to compare the continuous values and chi-squared or Fisher's exact test was used to compare the categorized values.
Sacroiliitis was identified in 514 of 4827 patients (10.6%). Patients with sacroiliitis were significantly younger than those without sacroiliitis (32.1 ± 8.9 vs. 35.8 ± 9.5 years, p < 0.001). Moreover, significantly more patients with sacroiliitis had HLA-B27 (p < 0.001) positivity and inflammatory back pain syndrome (p = 0.003) than those without sacroiliitis. Among the 514 patients, sacroiliitis was recognized on primary reading in 386 patients (75.1%) but was neglected in the remaining 128 patients (24.9%). Of the 386 patients, 371 patients were followed up, and finally, 295 patients of them (79.5%) were diagnosed with axSpA.
Radiologists should pay careful and more attention to sacroiliac joint on lumbar spine CT for early diagnosis of sacroiliitis in young patients with low back pain, which could result in early diagnosis and treatment of axSpA.
本研究旨在调查腰痛患者腰椎计算机断层扫描（CT）中骶髂关节炎的患病率和漏诊率。
本回顾性研究纳入了2016年1月至2020年12月期间共4827例行腰椎CT检查的患者（平均年龄：35.4±9.5岁）。两名放射科医生对所有研究人群的骶髂关节炎CT程度进行了回顾性评估。采用独立样本t检验比较连续值，采用卡方检验或Fisher精确检验比较分类值。
4827例患者中有514例（10.6%）被诊断为骶髂关节炎。骶髂关节炎患者比无骶髂关节炎患者明显年轻（32.1±8.9岁 vs. 35.8±9.5岁，p<0.001）。此外，与无骶髂关节炎的患者相比，骶髂关节炎患者中HLA - B27阳性（p<0.001）和炎性背痛综合征（p = 0.003）的患者明显更多。在这514例患者中，386例（75.1%）在初次阅片时被诊断为骶髂关节炎，其余128例（24.9%）被漏诊。在386例患者中，371例接受了随访，最终其中295例（79.5%）被诊断为轴性脊柱关节炎。
放射科医生应在腰椎CT上仔细并更加关注骶髂关节，以便对年轻腰痛患者的骶髂关节炎进行早期诊断，从而实现轴性脊柱关节炎的早期诊断和治疗。
