Nancy A Chauvin1, Rui Xiao2,3, Timothy G Brandon4, David M Biko5, Michael Francavilla5, Dmitry Khrichenko5, Pamela F Weiss3,4,6. 1. 1 Department of Radiology, Hershey Children's Hospital, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, 500 University Dr, Hershey, PA 17033. 2. 2 Department of Pediatrics, Division of Biostatistics, Children's Hospital of Philadelphia, Philadelphia, PA. 3. 3 Department of Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 4. 4 Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA. 5. 5 Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA. 6. 6 Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Abstract
OBJECTIVE: Increasing reliance on MRI for the evaluation of sacroiliitis requires that radiologists be familiar with the normal appearance of the developing sacroiliac joint. We describe age-related MRI features of the sacroiliac joints in healthy children. SUBJECTS AND METHODS: Seventy healthy children from three age groups-prepubertal (8-10 years), peripubertal (11-13 years), and approaching skeletal maturity (14-17 years)-completed questionnaires and underwent sacroiliac joint MRI. Imaging studies were evaluated by three experienced pediatric radiologists. Metaphyseal-equivalent signal intensity, nonperiarticular osteitis, cartilage volume, joint fluid, enthesitis, and surface cortex irregularities were evaluated. Metaphyseal-equivalent signal intensity was evaluated using an ordinal grading system (types I-IV). Intraclass correlation coefficients were calculated to assess interrater reliability. RESULTS: Increased metaphyseal-equivalent signal intensity (types I and II) was present in most prepubertal children and in less than 10% of the group approaching skeletal maturity. More prepubertal girls had type I signal than boys, but signal progressed to type IV signal faster in girls than in boys. None of the subjects had subchondral marrow edema, but four subjects had nonperiarticular osteitis. Cartilage volumes decreased with advancing age in girls and, on average, were lower in girls than in boys of the same age. One subject had measurable joint fluid. Cortex irregularities were common (57.1%), most frequently seen along the iliac bone (51.4% ilium vs 11.4% sacrum, p < 0.01) and in the upper quadrants (42.8% upper vs 27.1% lower, p = 0.01). CONCLUSION: We provide valuable reference MRI descriptions of the healthy pediatric sacroiliac joint that should improve our ability to distinguish between normal and pathologic findings.
OBJECTIVE: Increasing reliance on MRI for the evaluation of sacroiliitis requires that radiologists be familiar with the normal appearance of the developing sacroiliac joint. We describe age-related MRI features of the sacroiliac joints in healthy children. SUBJECTS AND METHODS: Seventy healthy children from three age groups-prepubertal (8-10 years), peripubertal (11-13 years), and approaching skeletal maturity (14-17 years)-completed questionnaires and underwent sacroiliac joint MRI. Imaging studies were evaluated by three experienced pediatric radiologists. Metaphyseal-equivalent signal intensity, nonperiarticular osteitis, cartilage volume, joint fluid, enthesitis, and surface cortex irregularities were evaluated. Metaphyseal-equivalent signal intensity was evaluated using an ordinal grading system (types I-IV). Intraclass correlation coefficients were calculated to assess interrater reliability. RESULTS: Increased metaphyseal-equivalent signal intensity (types I and II) was present in most prepubertal children and in less than 10% of the group approaching skeletal maturity. More prepubertal girls had type I signal than boys, but signal progressed to type IV signal faster in girls than in boys. None of the subjects had subchondral marrow edema, but four subjects had nonperiarticular osteitis. Cartilage volumes decreased with advancing age in girls and, on average, were lower in girls than in boys of the same age. One subject had measurable joint fluid. Cortex irregularities were common (57.1%), most frequently seen along the iliac bone (51.4% ilium vs 11.4% sacrum, p < 0.01) and in the upper quadrants (42.8% upper vs 27.1% lower, p = 0.01). CONCLUSION: We provide valuable reference MRI descriptions of the healthy pediatric sacroiliac joint that should improve our ability to distinguish between normal and pathologic findings.
Authors: Michael L Francavilla; Suraj D Serai; Timothy G Brandon; David M Biko; Dmitry Khrichenko; Jie C Nguyen; Rui Xiao; Nancy A Chauvin; Liya Gendler; Pamela F Weiss Journal: ACR Open Rheumatol Date: 2021-11-10
Authors: Pia Zadig; Elisabeth von Brandis; Paola d'Angelo; Laura Tanturri de Horatio; Lil-Sofie Ording-Müller; Karen Rosendahl; Derk Avenarius Journal: Pediatr Radiol Date: 2022-04-21
Authors: Pamela F Weiss; Walter P Maksymowych; Rui Xiao; David M Biko; Michael L Francavilla; Robert G Lambert; Jacob L Jaremko; Merav Heshin-Bekenstein; Timothy G Brandon; Nancy A Chauvin Journal: Arthritis Res Ther Date: 2020-03-24 Impact factor: 5.156