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Generel imaging aspects
Sacroiliitis - radiography
Sacroiliitis - MRI
Spine - radiography
Spine - MRI
Spinal fractures
Other joints
Diagnosis of sacroiliitis by radiography

For many years conventional radiography has been used to diagnose sacroiliitis, and the findings by radiography are still part of the accepted international diagnostic criteria for ankylosing spondylitis. The method can only show structural damage of the joints and/or bone. The diagnosis can therefore be difficult to obtain and may be delayed for many years unless radiography early in the disease is replaced or supplemented by cross sectional imaging (CT or MRI).

The severity of sacroiliac joint changes is usually classified according to the New York criteria in 5 stages.

  • Grade 0: Normal findings.
  • Grade 1: Suspicious changes.
  • Grade 2: Minimal abnormality with small areas of erosions or sclerosis without alteration in the joint width.
  • Grade 3: Unequivocal abnormality - moderate or advanced sacroiliitis consisting of erosion, sclerosis, widening, narrowing, and/or partial joint fusion (ankylosis).
  • Grade 4: Severe abnormality in the form of total ankylosis.

http://www.ncbi.nlm.nih.gov/pubmed/6231933.

 
Grade 0

Normal findings.

 
Grade 1

Suspicious changes at the left sacroiliac joint in the form of slightly irregular joint facets.

 
Grade 2

Minimal abnormalities in the form of small erosions (black arrow) and slightly condensed bone (sclerosis)(white arrow).

 
Grade 3

Manifest abnormalities in the form of erosion and sclerosis in addition to widening of the middle part of both sacroiliac joints.

 
Grade 4
Total ankylosis of both sacroiliac joints.
 
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