PURPOSE: The aim of this study was to evaluate the advantages of MRguided injections of corticosteroids into the sacroiliac joints (SIJ) in patients suffering from refractory sacroiliitis despite appropriate oral therapy. MATERIALS AND METHODS: At a lowfield open MR, we performed twentyfour infiltrations in 12 patients suffering from persistent buttock pain. Clinical followup and laboratory findings were evaluated every 4 up to 6 weeks. A subjective rating using a dolorimetry scale (0= no pain, up to=10 for most severe pain) was assessed prior to intervention and at three months followup. Morphological changes of the SIJ were examined on a 1.5 Tesla imager before and three months after steroid injections. RESULTS: Adequate positioning of the needle was obtained in all but one case due to a software defect. Clinical improvement was observed in 10 patients with a mean painfree period of 9.6 months. Dolorimetry index decreased from 7.6 +/- 1.5 to 2.9 +/- 1.5. Nonsteroidal antiinflammatory drugs could be discontinued in 4 patients and reduced in 4 others. CONCLUSION: We therefore conclude that MRguided injection of the SIJ is feasible and could be preferred to more conventional methods when technical equipment is available.
PURPOSE: The aim of this study was to evaluate the advantages of MRguided injections of corticosteroids into the sacroiliac joints (SIJ) in patients suffering from refractory sacroiliitis despite appropriate oral therapy. MATERIALS AND METHODS: At a lowfield open MR, we performed twentyfour infiltrations in 12 patients suffering from persistent buttock pain. Clinical followup and laboratory findings were evaluated every 4 up to 6 weeks. A subjective rating using a dolorimetry scale (0= no pain, up to=10 for most severe pain) was assessed prior to intervention and at three months followup. Morphological changes of the SIJ were examined on a 1.5 Tesla imager before and three months after steroid injections. RESULTS: Adequate positioning of the needle was obtained in all but one case due to a software defect. Clinical improvement was observed in 10 patients with a mean painfree period of 9.6 months. Dolorimetry index decreased from 7.6 +/- 1.5 to 2.9 +/- 1.5. Nonsteroidal antiinflammatory drugs could be discontinued in 4 patients and reduced in 4 others. CONCLUSION: We therefore conclude that MRguided injection of the SIJ is feasible and could be preferred to more conventional methods when technical equipment is available.