Clinic of Radiology, Afyonkarahisar Suhut State Hospital, Afyonkarahisar, Turkey
Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
Diagn Interv Radiol. 2023 Mar 29;29(2):390-395. doi: 10.5152/dir.2022.211018. Epub 2023 Feb 10.
Apart from a few case reports, sacroiliac joint (SIJ) involvement in osteochondromatosis has not been studied. We aimed to determine the prevalence and characteristics of such involvement using cross-sectional imaging.
In this retrospective study, three observers (one junior radiologist and two musculoskeletal radiologists) independently reviewed computed tomography (CT) or magnetic resonance imaging (MRI) of patients in our database who had osteochondromatosis (≥2 osteochondromas across the skeleton) for SIJ involvement. The final decision was reached by the consensus of the two musculoskeletal radiologists in a later joint session.
Of the 36 patients with osteochondromatosis in our database, 22 (61%) had cross-sectional imaging covering SIJs (14 females, 8 males; age range 7-66 years; mean age 23 years; 13 MRI, 9 CT). Of these, 16 (73%) had intra-articular osteochondromas. For identifying SIJ osteochondromas on cross-sectional imaging, interobserver agreement was substantial [κ = 0.67; 95% confidence interval (CI): 0.34, 1.00] between the musculoskeletal radiologists and moderate (κ = 0.59; 95% CI: 0.23, 0.94) between the junior radiologist and the final consensus decision of the two musculoskeletal radiologists. In the cohort with cross-sectional imaging, the anatomical variations of the accessory SIJ (n = 6, 27%) and iliosacral complex (n = 2, 9%) were identified in six different patients with (n = 2) and without (n = 4) sacroiliac osteochondromas.
Cross-sectional imaging shows frequent (73%) SIJ involvement in osteochondromatosis, which, although a rare disorder, nevertheless needs to be considered in the differential diagnosis of such SIJ anatomical variants as the accessory SIJ and iliosacral complex. Differentiating these variants from osteochondromas is challenging in patients with osteochondromatosis.
除了少数病例报告外，尚无人研究过骸骼关节（SIJ）在骨软骨瘤病中的受累情况。我们旨在使用横断面成像来确定这种受累的患病率和特征。
在这项回顾性研究中，三位观察者（一位初级放射科医师和两位肌肉骨骼放射科医师）分别独立审查了我们数据库中患有骨软骨瘤病（骨骼上至少有 2 个骨软骨瘤）的患者的 CT 或 MRI 图像，以评估其 SIJ 受累情况。最终决定由两位肌肉骨骼放射科医师在以后的联合会议上达成共识。
在我们的数据库中，有 36 名患有骨软骨瘤病的患者接受了涵盖 SIJ 的横断面成像检查（14 名女性，8 名男性；年龄范围 7-66 岁；平均年龄 23 岁；13 例 MRI，9 例 CT）。其中，16 例（73%）存在关节内骨软骨瘤。在识别 SIJ 骨软骨瘤方面，两位肌肉骨骼放射科医师之间的观察者间一致性很高（κ=0.67；95%置信区间[CI]：0.34，1.00），初级放射科医师与两位肌肉骨骼放射科医师最终达成的共识决策之间的观察者间一致性为中度（κ=0.59；95%CI：0.23，0.94）。在有横断面成像的队列中，在 6 名不同的患者中发现了副骸骼关节（n=6，27%）和骸骼复合体（n=2，9%）的解剖变异，这些患者中（n=2）存在和（n=4）不存在骸骼骨软骨瘤。
横断面成像显示骨软骨瘤病中 SIJ 受累频繁（73%），尽管该病较为罕见，但在鉴别副骸骼关节和骸骼复合体等 SIJ 解剖变异时仍需考虑到该病。在患有骨软骨瘤病的患者中，区分这些变异与骨软骨瘤具有挑战性。
