Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Department of Radiology and Nuclear Medicine - Division of Pediatric Radiology, Princess Elisabeth Children's Hospital/Ghent University Hospital, Ghent, Belgium.
Semin Musculoskelet Radiol. 2023 Oct;27(5):588-595. doi: 10.1055/s-0043-1772169. Epub 2023 Oct 10.
This opinion article by the European Society of Musculoskeletal Radiology Arthritis and Pediatric Subcommittees discusses the current use of conventional radiography (CR) of the sacroiliac joints in adults and juveniles with suspected axial spondyloarthritis (axSpA). The strengths and limitations of CR compared with magnetic resonance imaging (MRI) and computed tomography (CT) are presented.Based on the current literature and expert opinions, the subcommittees recognize the superior sensitivity of MRI to detect early sacroiliitis. In adults, supplementary pelvic radiography, low-dose CT, or synthetic CT may be needed to evaluate differential diagnoses. CR remains the method of choice to detect structural changes in patients with suspected late-stage axSpA or established disease and in patients with suspected concomitant hip or pubic symphysis involvement. In children, MRI is the imaging modality of choice because it can detect active as well as structural changes and is radiation free.
这篇由欧洲肌肉骨骼放射学会关节炎和儿科小组委员会撰写的观点文章讨论了在疑似中轴型脊柱关节炎（axSpA）的成人和青少年中，常规放射摄影（CR）检查骶髂关节的当前应用。文中介绍了 CR 与磁共振成像（MRI）和计算机断层扫描（CT）相比的优缺点。
基于目前的文献和专家意见，小组委员会认识到 MRI 在检测早期骶髂关节炎方面具有更高的敏感性。在成人中，可能需要补充骨盆 X 线摄影、低剂量 CT 或合成 CT 来评估鉴别诊断。对于疑似晚期 axSpA 或已确诊疾病的患者，以及疑似同时存在髋关节或耻骨联合受累的患者，CR 仍然是检测结构变化的首选方法。在儿童中，由于 MRI 能够检测活动性和结构性变化且无辐射，因此是首选的影像学检查方法。
