Ożga Joanna, Ostrogórska Monika, Wojciechowski Wadim, Żuber Zbigniew
Department of Pediatrics, Faculty of Medicine, Andrzej Frycz Modrzewski Krakow University, Gustawa Herlinga-Grudzińskiego 1, 30-705 Krakow, Poland.
Clinical Department of Pediatrics and Rheumatology, St. Louis Regional Specialised Children's Hospital, Strzelecka 2, 31-503 Krakow, Poland.
J Clin Med. 2024 Nov 26;13(23):7147. doi: 10.3390/jcm13237147.
Sacroiliitis in children is usually connected with one of the subtypes of juvenile idiopathic arthritis (JIA), such as enthesitis-related arthritis, psoriatic arthritis, or undifferentiated arthritis. The main diagnostic method is magnetic resonance imaging (MRI) of the sacroiliac joints, which can reveal bone marrow edema (BME) as a sign of an active inflammation process. This research aimed to retrospectively investigate the associations between the clinical presentation, laboratory test results, and MRI results of the sacroiliac joints of children. A total of 152 paediatric patients who underwent MRI of the sacroiliac joints were included in this single-centre study. The mean age of patients was 13.91 ± 2.97, while the female-to-male ratio was 1.36:1. JIA diagnosis was confirmed in 91 (59.87%) patients. The main symptom reported by 128 (83.21%) patients was chronic pain, while in another 40 (31.25%) patients, it was chronic back pain. Patients with arthritis and BME in the sacroiliac joints were more likely to report chronic back pain, while patients with JIA but without BME in the sacroiliac joints were often positive for anti-nuclear antibodies (ANA). The widening of any joint contour was observed in 43 (28.29%) patients, and reduced joint mobility was observed in 61 (40.13%). Elevation of inflammatory blood parameters occurred in 31 (20.39%) patients, but this was not statistically related to BME presence in the sacroiliac joints. Radiological findings included BME (n = 36; 23.68% of examinations), joint space narrowing (n = 10; 27.78% of examinations), erosions (n = 7; 19.44% of examinations), and joint fluid (n = 7; 19.44% of examinations). There was a statistically significant relationship between the presence of BME in the sacroiliac joints and all of the above radiological findings. The radiological findings of MRI of the sacroiliac joints are significantly statistically related to chronic back pain in patients, while there is no relationship between any inflammatory blood parameter and the presence of BME.
儿童骶髂关节炎通常与幼年特发性关节炎（JIA）的亚型之一相关，如附着点炎相关关节炎、银屑病关节炎或未分化关节炎。主要诊断方法是骶髂关节的磁共振成像（MRI），其可显示骨髓水肿（BME）作为活跃炎症过程的迹象。本研究旨在回顾性调查儿童骶髂关节的临床表现、实验室检查结果和MRI结果之间的关联。本单中心研究纳入了152例接受骶髂关节MRI检查的儿科患者。患者的平均年龄为13.91±2.97，男女比例为1.36:1。91例（59.87%）患者确诊为JIA。128例（83.21%）患者报告的主要症状为慢性疼痛，另有40例（31.25%）患者为慢性背痛。骶髂关节有关节炎和BME的患者更易报告慢性背痛，而骶髂关节有JIA但无BME的患者抗核抗体（ANA）通常呈阳性。43例（28.29%）患者观察到任何关节轮廓增宽，61例（40.13%）患者观察到关节活动度降低。31例（20.39%）患者出现炎症血液参数升高，但这与骶髂关节中BME的存在无统计学关联。放射学表现包括BME（n = 36；23.68%的检查）、关节间隙变窄（n = 10；27.78%的检查）、侵蚀（n = 7；19.44%的检查）和关节积液（n = 7；19.44%的检查）。骶髂关节中BME的存在与上述所有放射学表现之间存在统计学显著关系。骶髂关节MRI的放射学表现与患者的慢性背痛在统计学上显著相关，而任何炎症血液参数与BME的存在之间均无关联。
