Purpose and background:. Sacroiliitis identified by MRI is considered as a keystone in the diagnosis of spondyloarthritis. To reduce the number of unnecessary MRI scans it would be ideal if sacroiliac (SI) joint pain provocation tests could be used to identify patients at risk of having sacroiliitis. The aim of the current study was to investigate the diagnostic value of three pain provocation SI-joint tests for sacroiliitis identified by MRI. Methods:. Patients (n=454, mean age 32 years, 54% women) without clinical signs of nerve root compression were selected from a cohort consisting of patients with persistent low back pain referred to an outpatient spine clinic. Data from the Gaenslen's Test, Thigh Thrust Test and Long Dorsal Sacroiliac Ligaments Test and sacroiliitis identified by MRI were analysed. Results:. The prevalence of SI-joints with sacroiliitis was 5%. In the whole study group, only the Thigh Trust Test was associated with sacroiliitis, ROC area 0.58 (95% CI 0.51–0.65), sensitivity 31% (18–47) and specificity 85% (82–87). In men, sacroiliitis was associated with all three SI joint tests and multitest regimens, with the greatest ROC area found for ≥ 1 positive out of 3 tests, (0.68 (0.56–0.80)), sensitivity 56% (31–79) and specificity 81% (77–85). In women, no significant associations were observed between the assessed SI joint tests and sacroiliitis. Conclusions:. Only in men were the performed SI-joint tests found to be associated with sacroiliitis identified by MRI. Although, the diagnostic value was limited, the results indicate that the use of SI joint tests for sacroiliitis may be optimised by gender-separated analyses

Purpose and Background:. The spread of upright MRi scanning is a relatively new development in the UK. However, there is a lack of information about whether weight bearing scans confer any additional useful information for low back conditions. Methods and Results:. Forty-five patient referrals to the upright MRI Department at the AECC for weight bearing lumbar spine scans between November 1. st. 2014 and June 30. th. 2015, and the resulting radiologists' reports were reviewed. Age, gender, clinical history, summary of findings, type of weight bearing scanning performed (sitting, standing, flexion, extension) were abstracted. All patients were scanned in a 0.5T Paramed MRopen scanner and all also received supine lumbar spine sagittal and axial scans. The patients comprised 18 females and 27 males, mean age 52 years, (SD 15.5). Thirty had leg pain, 6 of which was bilateral. In 15, a stenotic lesion was suspected. Other reasons for referral were; possible malignancy (1), effects of degenerative change (4), spondylolisthesis (2), fracture, (1), previous surgery (3), trauma (1), sacroiliitis (1) and instability (3). In 12/45 cases, reportable findings were more prominent, and sometimes only identifiable, on weight bearing scans, while in a further 4, the reverse was true. All but one of these involved disruption of the spinal or root canals. Eight of them also involved positional alignment. Conclusion:. In this case series nearly a third of referred patients had reportable findings relating to the spinal or nerve root canals that were differentiated by upright MRI scans

Aims

To investigate the correlations among cytokines and regulatory T cells (T-regs) in ankylosing spondylitis (AS) patients, and their changes after anti-tumour necrosis factor-α (TNF-α) treatment.

Back pain is a common symptom in children and adolescents. Here we review the important causes, of which defects and stress reactions of the pars interarticularis are the most common identifiable problems. More serious pathology, including malignancy and infection, needs to be excluded when there is associated systemic illness. Clinical evaluation and management may be difficult and always requires a thorough history and physical examination. Diagnostic imaging is obtained when symptoms are persistent or severe. Imaging is used to reassure the patient, relatives and carers, and to guide management.

Cite this article: Bone Joint J 2014;96-B:717–23.