Normal morphology of sacroiliac joints in children: magnetic resonance studies related to age and sex |
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Authors: | M Bollow J Braun J Kannenberg T Biedermann C Schauer-Petrowskaja S Paris S Mutze B Hamm |
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Institution: | Institut für R?ntgendiagnostik, Charite′, Humboldt-Universit?t zu Berlin, Schumannstrasse 20–21, D-10098 Berlin, Germany, DE Department of General Internal Medicine and Rheumatology, Klinikum Benjamin Franklin, Freie Universit?t Berlin, Berlin, Germany, DE Department of Juvenile Rheumatology, II. Kinderklinik, Krankenhaus Berlin Buch, Berlin, Germany, DE
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Abstract: | Objective. To determine in a prospective study the normal MRI morphology of the sacroiliac joints (SIJs) in relation to age and sex
during adolescence. Design and patients. A total of 98 children (63 boys, mean age 12.7±2.8 years; 35 girls, mean age 13.7±2.3 years), ranging in age from 8 to 17
years, with juvenile chronic arthritis (JCA) but without signs of sacroiliitis fulfilled the study prerequisites (no back
pain and no pathologic changes of the SIJs on physical examination before MRI in a 1.5-year follow-up). An additional eight
HLA-B27-negative boys and eight HLA-B27-negative girls without arthritis served as controls. The MRI protocol comprised a
T1-weighted SE sequence, an opposed-phase T2*-weighted GE sequence, and a dynamic contrast-enhanced study in single-section
technique. Results. Noncontrast MRI permitted differentiation of “open” from ossified segmental and lateral apophyses of the sacral wings, with
a significant difference in age (P <0.05) between children with open and ossified apophyses. Ossification of the apophyses of the sacral wings was seen significantly
earlier (P <0.05) in girls than in boys. Girls also had a significantly higher incidence of transitional lumbosacral vertebrae, pelvic
asymmetries, and accessory joints. In the contrast-enhanced opposed-phase MRI study, normal cartilage of the SIJs showed no
contrast enhancement whereas the joint capsule showed a moderate enhancement. Conclusion. There are significant age- and sex-related differences in the normal MRI morphology of juvenile SIJs. Our findings might
serve as a standard of comparison for the evaluation of pathologic changes – in particular for the early identification of
juvenile sacroiliitis. |
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Keywords: | Joints sacroiliac Children skeletal system MR contrast enhancement Arthritis in infants and children |
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