| Objective(1) To discuss the CT anatomical characteristics of sacroiliac joint and their measurements, in order to provide the anatomic basis for diagnosing and treating the disease of sacroiliac joint.(2) To discuss the standard of diagnosis on sacroiliac arthritis and their CT characteristics.Methods CT date of 557 subjects from the PACS of our hospital from 2014.01 to 2014.07, including 359 subjects of normal group(age from 20 to 93 years old, without significant lesions on the sacroiliac joint disease,)and 198 subjects of disease group(age from 13 to 67 years old,according to the diagnostic criteria).The anatomical parameters of the strucutures of sacroiliac joint was measured obtaining CT images. Statistical methods include T test, one-way ANOVA analysis and chi square test, P<0.05 is significant difference criterion.Results(1) The normal group:there was 718 sides of sacroiliac joints, 393 sides of linear type joint(male 291, female 102),325 sides of “S” type joint(male 135, female 190), there was significant difference between male and female group. Joint space width was 2.28 + 0.81 mm, there were significants difference both male and female group and different age groups. Lateral iliac bone thickness was 1.42 + 0.49 mm, Lateral sacral bone thickness was 1.33 + 0.37 mm. male and female group had significants difference of lateral iliac bone thickness. It was found that intra-articular sacroiliac joint vacuum sign in 343 side(right 169, left 174; male 147, female 196; linear type 178,type S 165), there was significant difference between male and female group. Articular surface was found discontinuity, cysts, bone sclerosis. The iliac side respectively: 85 side, 141 side, 29 side; sacral side respectively: 91 side, 19 side, 0 side, there was significant difference in different age groups. Sacral anterior margin appeared bone hyperplasia is 90 sides; Iliac anterior margin appeared bone hyperplasia is 237 sides;only 1 side of bone hyperplasia occurred in the posterior sacral bone hyperplasia and 17 sides of hyperosteogenyoccurs in the posterior inferior margin. there was significant difference in different age groups.(2) The disease groups: the patients who had sacroiliac arthritis were divided into four groups according to the cause: 103 were diagnosed as ankylosing spondylitis.Forty-three cases were diagnosed as sclerosing osteitis. Twenty-two cases were diagnosed as sacroiliar joint degeneration. Thirty cases were unexplained arthritis.Each disease group in line type of sacroiliac joints respectively:125, 26, 6, 19;S type respectively:81, 60, 38, 41;the male respectively:70, 2, 5, 14,the women respectively: 33, 41, 17, 16.Vacuum syndrome rate respectively were 23%, 53%, 77%, 52% in four groups. Joint type, gender and vacuum sign were statistical difference among the groups. Joint space width(mm) were 1.73 + 1.43, 2.03 + 0.58, 2.31 + 0.61, 2.02 + 0.70,there was no significant difference between sclerosing osteitis group and unexplained arthritis group. Lateral iliac bone thickness(mm) were 4.17 + 3.69, 3.76 + 3.41, 1.59 +1.30, 1.94 + 1.73, ankylosing spondylitis group and sclerosing osteitis group, sacroiliar joint degeneration group and unexplained arthritis group showed no significant difference. Lateral sacral bone thickness(mm) were 1.92±1.60、1.60±1.42、1.18±0.30、1.27±0.36,there was no significant difference between sacroiliar joint degeneration group and unexplained arthritis group. In addition, ankylosing spondylitis group had 17 cases of sacroiliac joint bilateral ankylosis, 2 cases of unilateral joint fusion, 2 cases of unilateral lower fusion joint.Conclusion(1) Linear type of sacroiliac joint is more common in male, “S” type in female. The width of normal joint space is 2.28 + 0.81mm; thickness of iliac bone cortex is 1.42 + 0.49mm; thickness sacral bone cortex is 1.34 + 0.37 mm. Vacuum phenomenon of sacroiliac joint is higher in the famale than male; group of sacroiliar joint degeneration is higher than normal group, while the group of ankylosing spondylitis is much lower than that the normal group.(2) Ankylosing spondylitis often occurs in the Linear type. Vacuum phenomenon often find in the sacroiliar joint degeneration. Ankylosing spondylitis is more common in male, while sclerosing osteitis and sacroiliar joint degeneration are more common in female. Joint space narrowing or disappearance appeared more common in ankylosing spondylitisgroup. Cortical thickening of sacroiliac joint is more common in ankylosing spondylitis group and sclerosing osteitis group.(3) CT images can clearly display the sacroiliac joint and surrounding structure, it is an important examination method for diagnosing on sacroiliitis. |
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