MRI下骶髂关节炎的临床鉴别诊断

影像学一直是诊断和评估骶髂关节炎的重要手段。核磁共振成像可早期发现并评估骶髂关节改变，在诊断骶髂关节炎相关疾病及协助临床决策方面具有重要作用。临床上引起骶髂关节炎的疾病很多，如脊柱关节炎、关节退行性改变、感染、肿瘤等。临床中误诊原因多为对影像学的误读所致，且误诊给社会及患者带来巨大精神及经济负担。本文总结了骶髂关节在脊柱关节炎及相关鉴别诊断中的MRI影像学特点，强调临床工作中，影像学提示出现骶髂关节炎可能涉及如风湿免疫科、感染科、肿瘤科、内分泌等多学科的疾病。很多病例影像学虽然提示有骶髂关节炎改变，但临床医生在诊疗过程中更应结合患者的年龄、性别、体征、症状及实验室检查等相关临床特点加以综合分析和判断，避免误诊。因此，本文对不同疾病引起的骶髂关节炎的核磁共振表现做一综述。

Clinical differential diagnosis of sacroiliitis confirmed with magnetic resonance imaging

The imagings have always been an important means of diagnosing and assessing sacroiliitis. Magnetic resonance imaging (MRI) has the advantages of early detection to evaluate sacroiliitis in the diagnosis of diseases related to sacroiliitis and has an important role in clinical Decision making. There are many diseases related to sacroiliitis in the clinic, such as spondyloarthritis, joint degenerative, joint infections, and tumors. In clinic those misdiagnosis causes are mostly caused by misreading of the imagings, and misdiagnosis may cause great loss to the patient''s spirit and economy. This article summarizes the MRI features of the sacroiliac and clinical in spondyloarthritis and related differential diagnosis. In our clinical works, sacroiliitis suggested in imagings may be involved in rheumatology and immunology, hematology, endocrinology, infectious diseases,and tumors and so on. For some difficult cases, clinicians should combine the age, history, symptoms, signs, laboratory tests, and imaging examinations to analyze and judge it in a comprehensive manner to avoid misdiagnosis. Therefore, this article reviews the MRI findings of sacroiliitis caused by different diseases.