International Journal of Science and Research (IJSR)

International Journal of Science and Research (IJSR)
Open Access | Fully Refereed | Peer Reviewed

ISSN: 2319-7064


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Research Paper | Medicine Science | India | Volume 7 Issue 7, July 2018


Comparative Study of Imaging of Sacroiliitis by CT and MRI-Scan with Power Doppler Ultrasound in Spondyloarthritis

Samikrishnan P, Panchapakesa Rajendran C, Porkodi R


Abstract: INTRODUCTION Spondyloarthritides are the group of inflammatory disorders of unknown cause and these are often associated with human leukocyte antigen (HLA) -B27. In all these cases, the presence of sacroiliitis is considered as the hallmark of AxSpA and ankylosing spondylitis, but it take longer time to appreciate the radiological features of either sacroiliac or spinal inflammation. As everyone aware, early diagnosis and prompt initiation of non- biological or biological DMARD can arrest or prevent or delay the expected non remediable complications of SpA/AS. Mostly, clinicians are dependent on either MRI or CT scan for the diagnosis of spondyloarthritis, but it has its own merits and demerits. Thus, in our study, we have used low cost, everywhere and easily available power doppler ultrasound in early diagnosis of spondyloarthritis and systematically compared with MRI and CT- pelvis with an age matched healthy controls. AIM OF THE STUDY To diagnose Spondyloarthritis before radiological erosions. To compare Power Doppler imaging of sacroiliitis with conventional CT and MRI scan of Pelvis. OBJECTIVES OF THE STUDY Across the world, SpA/ AS is a significant burdens to young, reproductive and the potential earning population. If undiagnosed or inadequately treated, it not only causes continuous pain, stiffness and fatigue and it can lead to erosions, narrowing of joint space and complete ankylosis of spine and pelvic joints with resultant loss of nobilities and functions. To accept the truth that, approximately from the onset of symptoms to diagnosis of SpA/ AS is about 8 to 11 years. Added to that, SI joint is not easily palpated or manipulated and investigations like X-Rays, MRI, CAT Scans, Bone Scans are reported as normal if the observers are not having adequate knowledge in where and what to look for. Thus, miserably, patients may miss early diagnosis and appropriate initiation of treatment for SpA. Conventional x-ray pelvis are not suitable for picking up early synovial inflammation and erosions, hence we depends on the MRI and CT-SCAN, which are not easily available to everyone and expensive and risk of ionizing radiations, respectively. For a decade, power colour Doppler ultrasound is considered as extended hand of Rheumatologists and declared as the poor mans MRI and it remarkably help us in early diagnosis of synovitis, enthesitis, tenosynovitis, synovial effusions and proliferation, erosions of cartilage, bone joint margin, enchondral bone erosion, cyst, osteopenia and in crystal deposition diseases. MATERIALS AND METHODS In this prospective case control study from January 2007 to February 2009, one hundred and eight patients (84 males, 24 females) were included from those who have presented with signs and symptoms and clinical features suggestive of spondyloarthritis to the Department of Rheumatology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai.3. Thirty five age and sex matched asymptomatic controls were selected from patients attenders who were not a first or second degree relatives. All patients were asked for a detailed history which includes the age of onset of disease, symptoms of disease, duration of the disease and relevant symptoms of secondary AS. A detailed general examination, height and weight assessment was done and usual laboratory tests and all disease activity index scores were calculated. RESULTS One hundred and eight patients were recruited in this study. Among these, 84 were males and 24 were females (3.51). The mean age of patients was 30 11.10 years (range from 16 to 59 years). The average disease duration was 3.46 5.23 years (range from one month to 23 years). There were 35 age and sex matched controls (27 males, 8 females, mean age 30 11). CONCLUSION Both MRI and power Doppler ultrasound are 100 % sensitive in identifying sacroiliitis. CT-scan is a useful modality of imaging in sacroiliitis but it is not suitable for identifying the early synovial inflammation and erosions and it also has the risk of ionizing radiation. The poor man MRI, the Power Doppler ultrasound becomes the potent choice of tool for the early diagnosis of spondyloarthritis.


Keywords: Appendices Abbreviations SpA Spondyloarthropathies AxSpA Axial spondyloarthritis AS Ankylosing spondylitis uSpA Undifferentiated spondyloarthropathies ReA Reactive arthritis PsA Psoriatic arthritis IBD arthropathy Inflammatory bowel disease related arthropathy anti- TNF Anti- tumor necrosis factor HLA Human leukocyte antigen ESSG European Spondyloarthropathy Study Group CT scan Computerized Tomography scan MRI scan Magnetic Resonance Imaging scan STIR Short Tau Inversion Recovery T1FSE, T2FSE T 1& T 2 Fast Spin Echo ESR Erythrocyte Sedimentation Rate CRP C - Reactive Protein BASDAI Bath Ankylosing Spondylitis Disease Activity Index PDUS Power Doppler UltraSound CDDUS Color Duplex and Doppler UltraSound MSU Musculoskeletal Ultrasound SIJ Sacroiliac joints SI Sacroiliitis TV Thoraco Vertebral LV Lumbar Vertebral RI Resistive Index


Edition: Volume 7 Issue 7, July 2018,


Pages: 1318 - 1342


How to Cite this Article?

Samikrishnan P, Panchapakesa Rajendran C, Porkodi R, "Comparative Study of Imaging of Sacroiliitis by CT and MRI-Scan with Power Doppler Ultrasound in Spondyloarthritis", International Journal of Science and Research (IJSR), https://www.ijsr.net/get_abstract.php?paper_id=ART2019162, Volume 7 Issue 7, July 2018, 1318 - 1342

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Comparison between Transabdominal Ultrasound and Endoscopic Retrograde Cholangiopancreatography in the Detection of the Common Bile Duct Stone

Dr. Malallah Akreem Ammer, Dr. Yassir Sabeeh, Dr. Laith Hikmetmihsun

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Review Papers, Medicine Science, India, Volume 5 Issue 5, May 2016

Pages: 1764 - 1768

Role of Bite Mark in Forensic Odontology ? A Review

Dr. Shiva Kumar B, Dr. Deepthi. B. C.

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Research Paper, Medicine Science, India, Volume 4 Issue 9, September 2015

Pages: 2100 - 2101

Successful Management of Hypercalcaemia in Multi-Treated Milk Fever Cows

U. Umadevi, K. Saranya, P. Madhu Mathi, T. Umakanthan

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Research Paper, Medicine Science, Spain, Volume 9 Issue 3, March 2020

Pages: 1620 - 1624

Hyperbolic Curves in Medicine and the Earths Magnetic Field

Jesus M. Gonzalez-Gonzalez

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Research Paper, Medicine Science, India, Volume 3 Issue 6, June 2014

Pages: 1591 - 1598

Increasing Prevalence of Chronic Obstructive Pulmonary Disease;Tuberculosis; Lung Cancer and Rising Environmental Oestrogen

Elizabeth JeyaVardhini Samuel, Nagarajan Natarajan

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Research Paper, Medicine Science, Spain, Volume 9 Issue 3, March 2020

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Hyperbolic Curves in Medicine and the Earths Magnetic Field

Jesus M. Gonzalez-Gonzalez

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Research Paper, Medicine Science, India, Volume 3 Issue 6, June 2014

Pages: 1591 - 1598

Increasing Prevalence of Chronic Obstructive Pulmonary Disease;Tuberculosis; Lung Cancer and Rising Environmental Oestrogen

Elizabeth JeyaVardhini Samuel, Nagarajan Natarajan

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Research Paper, Medicine Science, Spain, Volume 9 Issue 3, March 2020

Pages: 1620 - 1624

Hyperbolic Curves in Medicine and the Earths Magnetic Field

Jesus M. Gonzalez-Gonzalez

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Research Paper, Medicine Science, India, Volume 3 Issue 6, June 2014

Pages: 1591 - 1598

Increasing Prevalence of Chronic Obstructive Pulmonary Disease;Tuberculosis; Lung Cancer and Rising Environmental Oestrogen

Elizabeth JeyaVardhini Samuel, Nagarajan Natarajan

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Research Paper, Medicine Science, India, Volume 3 Issue 8, August 2014

Pages: 772 - 778

Effect of Glycerin as Plasticizer in Orodissloving Films of Losartan Potassium

Aditya V. Sakhare

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Research Paper, Medicine Science, Macedonia, Volume 4 Issue 7, July 2015

Pages: 2550 - 2552

Prevalence of Coronal Pulp Stones in Mandibular First and Second Molars

Pavlina Aleksova

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Case Studies, Medicine Science, Malaysia, Volume 10 Issue 8, August 2021

Pages: 894 - 896

Post-Spinning Exercise Induced Rhabdomyolysis: A Case Report

Arvin Raj Goonasegaran, Kamaljeet Singh, Danusha Peralan, Amanda Hong, Habibah Abd. Halim, Harjeet Singh

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Research Paper, Medicine Science, India, Volume 4 Issue 2, February 2015

Pages: 1184 - 1191

A Randomized Controlled Study on Effect of Intravenous Paracetamol as a Pre-Emptive Analgesic In Patients Undergoing Hysterectomy

Dr. Prutvi Shetty MBBS, Dr. Naseema V. Kanase MBBS DA M D. Anaes, Dr. V. K. Dhulkhed. M D Anaes, Sandhya Jagadale Msc. N, Kavita Kapurkar Msc. N

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Case Studies, Medicine Science, Bulgaria, Volume 3 Issue 10, October 2014

Pages: 1332 - 1334

Possibility of Combined Assessment of Biomarkers in Early Parkinsons Disease

Dimitar Kochev, Julia Petrova, Maria Petrova, Dimo Krastev, Lachezar Traikov

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Case Studies, Medicine Science, India, Volume 7 Issue 1, January 2018

Pages: 1707 - 1708

A Case of Unusual Presentation of Takayasus Arteritis with Rheumatic Heart Disease

Dr. Viral Patel, Dr Kamal Pathak, Dr AlpeshVadher

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Case Studies, Medicine Science, India, Volume 7 Issue 1, January 2018

Pages: 1707 - 1708

A Case of Unusual Presentation of Takayasus Arteritis with Rheumatic Heart Disease

Dr. Viral Patel, Dr Kamal Pathak, Dr AlpeshVadher

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Research Paper, Medicine Science, Albania, Volume 3 Issue 12, December 2014

Pages: 2421 - 2424

Evaluation of Procalcitonin in Adult Patients with Fever

Edmond Puca, Arben Pilaca, Entela Y Puca, Gentian Stroni, Elda Qyra, Ilir Akshija, Gentian Huti, Anila Laurence, Arben Pepa, Pellumb Pipero

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Research Paper, Medicine Science, Albania, Volume 4 Issue 6, June 2015

Pages: 984 - 986

The Relationship of Rheumatoid Factor with Disease Activity in Patients with Rheumatoid Arthritis

Artur Zoto, Brikena Selimi

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Comparative Studies, Medicine Science, India, Volume 6 Issue 7, July 2017

Pages: 60 - 62

The Utility of Acid Phosphatase as a Marker in Malaria

Dr. Jyoti Prakash Yogi, Dr. Mukesh Soni, Dr. D. Devpura

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Research Paper, Medicine Science, Zimbabwe, Volume 4 Issue 4, April 2015

Pages: 1696 - 1700

Investigation of the Suspending Properties of Dicerocaryum Zanguebarium and Adansonia Digitata Mucilage as Structured Vehicles

Tapiwa Manyarara, Joy Chifamba, Precious Derera

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Research Paper, Medicine Science, Albania, Volume 4 Issue 6, June 2015

Pages: 984 - 986

The Relationship of Rheumatoid Factor with Disease Activity in Patients with Rheumatoid Arthritis

Artur Zoto, Brikena Selimi

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Research Paper, Medicine Science, Albania, Volume 4 Issue 3, March 2015

Pages: 2210 - 2212

Risk Factors in Heart Attack

Edi Smajlaj, Sabit Brokaj

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Research Paper, Medicine Science, Saudi Arabia, Volume 6 Issue 1, January 2017

Pages: 2450 - 2458

Awareness on Diabetes Complications and Protective Measures in Makkah Region among Known Diabetic Patients: A Cross-Sectional Survey

Anoud R. Omer; Abdullah A. Alghamdi; Rakan A. AlYamani; Salman H. Alqurash; Abdulaziz A. Alshikh; Roa'a A. Alshaik; Mohamed E. Salih; Anees A Sindi

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Research Paper, Medicine Science, Bulgaria, Volume 4 Issue 4, April 2015

Pages: 3355 - 3359

Is there a Marker to Predict Restenosis After Carotid Stenting?

Petova J, Manolov V, Velchev V, Milev B, Vasilev V, Tzatchev K, Marinov B

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Research Paper, Medicine Science, Albania, Volume 3 Issue 12, December 2014

Pages: 2421 - 2424

Evaluation of Procalcitonin in Adult Patients with Fever

Edmond Puca, Arben Pilaca, Entela Y Puca, Gentian Stroni, Elda Qyra, Ilir Akshija, Gentian Huti, Anila Laurence, Arben Pepa, Pellumb Pipero

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Research Paper, Medicine Science, Spain, Volume 9 Issue 3, March 2020

Pages: 1620 - 1624

Hyperbolic Curves in Medicine and the Earths Magnetic Field

Jesus M. Gonzalez-Gonzalez

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Research Paper, Medicine Science, India, Volume 3 Issue 6, June 2014

Pages: 1591 - 1598

Increasing Prevalence of Chronic Obstructive Pulmonary Disease;Tuberculosis; Lung Cancer and Rising Environmental Oestrogen

Elizabeth JeyaVardhini Samuel, Nagarajan Natarajan

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