Niels Egund1, Flemming Brandt Sørensen2, René Østgård3, Anne Gitte Loft4, Lene Warner Thorup Boel5, Anne Grethe Jurik6. 1. Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 35, Entrance C, location C118/ reference point C109, 8200, Aarhus N, Denmark. 2. Department of Pathology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark. 3. Department of Rheumatology, Regional Hospital, Silkeborg, Falkevej 1G, 8600, Silkeborg, Denmark. 4. Department of Rheumatology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark. 5. Department of Forensic Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark. 6. Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 35, Entrance C, location C118/ reference point C109, 8200, Aarhus N, Denmark. annejuri@rm.dk.
Abstract
OBJECTIVE: To introduce and evaluate computed tomography (CT)-guided transarticular needle biopsy of the cartilaginous sacroiliac joint (SIJ) and to assess the biopsy results microscopically. MATERIALS AND METHODS: The new CT-guided transarticular biopsy of the SIJ was performed in a young corpse and ten patients, two males and eight females aged 18-81 years. All patients had abnormal findings by magnetic resonance imaging (MRI) of the SIJs, including bone marrow edema, related to different types of joint disorders. The biopsies were focused on areas with bone marrow edema. The quality of the specimens obtained, using two different types of biopsy needles, was assessed microscopically. RESULTS: Biopsies containing cartilage, subchondral plate, and bone marrow from the iliac and sacral sides were obtained from the corpse and three patients and from the iliac bone only in two patients. In three patients, the biopsy needles could not penetrate the bone marrow to the joint facet due to pronounced subchondral sclerosis, but adequate marrow biopsies were obtained. Two biopsies were inadequate, one due to technical problems and one was crushed during preparation. Histological assessment of eight adequate specimens revealed inflammatory bone marrow changes, except in two specimens from females with pronounced sclerosis conforming to osteitis condensans ilii. CONCLUSIONS: Transarticular SIJ biopsies are obtainable and can be directed towards areas with MRI abnormalities. They can be used to confirm inflammatory changes histologically. With the biopsy needles used, severe bone marrow sclerosis may hinder penetration to the cartilage, but bone marrow specimens can be obtained.
OBJECTIVE: To introduce and evaluate computed tomography (CT)-guided transarticular needle biopsy of the cartilaginous sacroiliac joint (SIJ) and to assess the biopsy results microscopically. MATERIALS AND METHODS: The new CT-guided transarticular biopsy of the SIJ was performed in a young corpse and ten patients, two males and eight females aged 18-81 years. All patients had abnormal findings by magnetic resonance imaging (MRI) of the SIJs, including bone marrow edema, related to different types of joint disorders. The biopsies were focused on areas with bone marrow edema. The quality of the specimens obtained, using two different types of biopsy needles, was assessed microscopically. RESULTS: Biopsies containing cartilage, subchondral plate, and bone marrow from the iliac and sacral sides were obtained from the corpse and three patients and from the iliac bone only in two patients. In three patients, the biopsy needles could not penetrate the bone marrow to the joint facet due to pronounced subchondral sclerosis, but adequate marrow biopsies were obtained. Two biopsies were inadequate, one due to technical problems and one was crushed during preparation. Histological assessment of eight adequate specimens revealed inflammatory bone marrow changes, except in two specimens from females with pronounced sclerosis conforming to osteitis condensans ilii. CONCLUSIONS: Transarticular SIJ biopsies are obtainable and can be directed towards areas with MRI abnormalities. They can be used to confirm inflammatory changes histologically. With the biopsy needles used, severe bone marrow sclerosis may hinder penetration to the cartilage, but bone marrow specimens can be obtained.
Authors: M Rudwaleit; A G Jurik; K-G A Hermann; R Landewé; D van der Heijde; X Baraliakos; H Marzo-Ortega; M Ostergaard; J Braun; J Sieper Journal: Ann Rheum Dis Date: 2009-05-18 Impact factor: 19.103
Authors: Janneke de Winter; Manouk de Hooge; Marleen van de Sande; Henriëtte de Jong; Lonneke van Hoeven; Anoek de Koning; Inger Jorid Berg; Roberta Ramonda; Dominique Baeten; Désirée van der Heijde; Angelique Weel; Robert Landewé Journal: Arthritis Rheumatol Date: 2018-05-23 Impact factor: 10.995