What shows the tomography of the sacroiliac joints. What is an MRI of the sacroiliac joints and what does it show MRI of the sacroiliac joints how is it done

Usually, there are not very many pathologies in the area of ​​the sacroiliac joints, so targeted scanning of this area is rarely required. Although there are many diagnostic methods, magnetic resonance imaging is considered the safest and most informative of them. It can detect any pathological changes in bone, cartilage, soft tissues, nerves and blood vessels even before the first clinical symptoms appear. This will allow timely start of treatment and avoid many negative consequences.

MRI can be performed at any age and even during pregnancy (except the first trimester), when other research methods are contraindicated. The method does not give radiation exposure to the body, is non-invasive and non-traumatic, as a rule, does not need special training and does not require long-term rehabilitation.

Magnetic resonance imaging of the sacroiliac joints allows you to get clear and detailed images of the problem area. They can be printed immediately or recorded on electronic media. The data obtained make it possible to build a three-dimensional image and examine the pathology from different angles. The duration of MRI of the sacroiliac joints does not exceed 30-40 minutes, and you can pick up the results already an hour after the completion of the study.

Using contrast

Sometimes, to obtain more accurate images, a joint scan with a preliminary injection of intravenous contrast agent is required. Contrast is usually used to diagnose vascular and tumor pathologies. Then the procedure will be longer than the usual MRI diagnostics by 10-15 minutes, which will be needed to administer the drug into the vein.

Safe preparations based on gadolinium are used as a contrast. They rarely cause an allergic reaction. Therefore, if you have a tendency to allergies or individual intolerance to gadolinium, as well as severe pathologies of internal organs and blood, then warn your doctor about this.

The injected contrast agent evenly spreads through the vessels of the whole body, concentrates in the tissues, which allows you to get a clearer picture on the pictures taken. No additional measures to remove the contrast are required. It will come out on its own after some time in a natural way and will not leave a trace.

When is an MRI of the sacroiliac joints needed?

Usually, an MRI of the sacroiliac joints is performed when the information obtained using other diagnostic methods is not enough to make an accurate diagnosis. The study may be prescribed if the following symptoms and conditions of the patient are present:

• injuries of varying severity in the scanning area;
• some general diseases of bone and cartilage tissues;
• uncharacteristic sounds when moving in the sacral region;
• sudden attacks of lameness;
• swelling and redness, feeling of heat in the sacrum;
• tension in the sacroiliac joint with a sharp movement;
• pain and discomfort in the lower back at rest and during movement;
• decreased flexibility of the spine and stiffness of movements;
• cramps in the calf muscles.

Such a scan is also necessary if there is a suspicion of the presence of tumors and vascular pathologies in the study area.

What does an MRI of the sacroiliac joints show?

An MRI scan of the sacroiliac joints and the images obtained during it will help to identify any pathological changes in the tissues that have fallen into the area being viewed. The method allows diagnosing diseases such as:

• tumor formations of various nature and cysts;
• pinching of the spinal cord and nerve roots;
• pathology of cartilaginous and bone tissues;
• ankylosing spondylitis and Reiter's syndrome;
• congenital and acquired anomalies of the structure;
• consequences of injuries;
• all types of arthritis;
• osteoarthritis and the appearance of bone growths;
• herniated intervertebral discs and protrusions;
• sacroiliitis, spondylosis and osteochondrosis;
• violation of blood circulation in the scanning area;
• encephalomyelitis and multiple sclerosis and others.

How to prepare for the procedure?

As a rule, MRI of the sacroiliac joints does not require any preparatory measures. There is no need to limit food intake, certain medications, physical activity. Before the procedure, you can lead a normal life.

If a contrast agent is to be administered, the study should be carried out on an empty stomach. In other cases, it is only important:

• remove jewelry and watches;
• wear loose clothing without metal inserts and details;
• free pockets from metal objects and electronic devices;
• remove a removable hearing aid, dental and other types of prostheses;
• take with you the previous results of the diagnosis of the problem area, if it was carried out.

For greater comfort, you can wear earplugs or special headphones before the MRI scan. During the procedure, you must remain completely still and calm, follow all the recommendations of a specialist.

The technique allows obtaining the most detailed information about the state of the joints and ligaments in the area of ​​the sacrum and iliac pelvic bones. MRI of the sacroiliac joints may be required in the presence of pain, as well as after injuries due to falls on the coccyx, jumping from a height, etc. This examination can be performed on young children and pregnant women (if indicated), as well as the elderly. Unlike X-ray diagnostics, the method does not exert radiation exposure on the patient and allows you to study the joints in the pelvic area in detail.

Exam duration: 20-30 minutes

Preparation for the examination: not required

Preparation of the conclusion: In one hour

Weight limit: up to 170 kg.

Examination cost: from 4400 rub.

You can use on-line registration:

Indications

MRI of the sacroiliac joints is indicated, firstly, if there is a suspicion of a violation of the normal structure of the joints and ligaments connecting the sacrum to the pelvic bones, and, secondly, if there is a suspicion of lesions of the sacrum itself and the pelvic bones. The most common diseases of the sacroiliac zone include:

• Bechterew's disease.
• Systemic lesions of the joints.
• Traumatic lesions of the pelvis.
• Tumors or metastases of the pelvic bones and internal organs of the pelvis.
• Osteoarthritis of the sacroiliac joint.
• Acute or chronic sacroiliitis.
• Inflammatory involvement of the sacroiliac joint in pelvic infections.

Symptoms that may indicate the presence of a lesion of the sacroiliac zone are both local and general:

• Pain in the pelvis. May radiate to the lower extremities.
• Decreased range of motion in the hip joint.
• Numbness of limbs.
• Lameness.
• Inability to stay in a sitting position for a long time.
• Painful or painless palpable masses in the pelvis.
• Increase in body temperature.
• General weakness.
• Pain in other joints.

Contraindications

MRI is one of the safest diagnostic methods. However, despite this, there are a number of absolute contraindications that preclude the performance of MRI diagnostics:

• Functioning pacemakers.
• Metal implants of any localization.
• Vascular clips of the brain.

Other contraindications such as pregnancy, the presence of peripheral or central neurostimulators, internal hearing aids and insulin pumps are relative, that is, the study can be performed with the expected high value of the results for the treatment process.

In addition, it is worth noting that the maximum allowable load on the tomograph installed in our clinic is 170 kg.

What does an MRI of the sacroiliac joints show?

• Damage to the articular-ligamentous apparatus in this area;
• Congenital changes in the sacroiliac joint in children;
• Degenerative and inflammatory processes;
• Metastases and tumor processes. MRI of the sacroiliac joints helps to detect neoplasms in the early stages, which is beyond the power of many other research methods.

How the study is done

MRI diagnostics of the sacroiliac joint is usually performed on patients in the supine position. However, given the presence of an open-type MRI machine in our center, the examination can also be performed in the “on the side” or “semi-sitting” position. Special preparation is not required. Women are recommended to undergo diagnostics on the days of the absence of menstruation.

The sequence of the patient's actions during an MRI study is as follows:

• Immediately before the procedure, all metal objects must be removed.
• Next, you need to take the desired position on the table.
• Directly during the operation of the tomograph, it is necessary to be in a stationary position for about 10-20 minutes and follow the instructions of the doctor.
• Analyze your well-being after the study - there should not be new complaints.
• Leave the diagnostic room and get the results of the study.

If the doctor is dissatisfied with the results of native MRI, the operation of the tomograph can be temporarily stopped during the scanning process, a contrast agent can be injected intravenously and the diagnostic process can be continued.

MRI sacroiliac joints with contrast

The contrast method improves the quality of the MRI image. This is achieved due to the difference in the distribution of the contrast agent between individual types of tissues, which increases the resolution of the image. Thus, the boundaries between pathological and healthy structures are more clearly visible.

Some soft tissue tumors are difficult to distinguish from lymph nodes during a routine MRI scan, requiring prior contrast enhancement. In addition, this procedure may also be required for severe edema of the soft tissues of the pelvis, when the boundaries of the inflammatory focus are poorly defined, which also requires contrasting.

The contrast agent is administered intravenously, and it is gradually excreted by the kidneys. Contrast is contraindicated if the patient has an allergy to the contrast agent, as well as in the end stage of renal failure.

Where to apply?

For those wishing to do an MRI of the sacroiliac joints, Moscow offers a large selection of clinics. However, there are few places where you can find the optimal combination that every person dreams of: low price, high-quality equipment, professional doctors, polite staff, the opportunity to be examined for adults and children. The diagnostic center "We and Children" meets all these criteria.

To The sacral iliac joint is a stiff joint that connects the pelvic bones to the spine. This zone experiences significant loads, working as a shock absorber, transferring the inertia of movement. If there is increased mobility in the joint, pain occurs that radiates to the legs and groin. When the mobility is small, the pain is unilateral localized and extends to the knee joint, sometimes to the ankle. Diagnosis of intervertebral hernias in the lumbar region and radiculopathies is difficult, therefore MRI of the sacroiliac joints is prescribed. This is a safe and informative method that allows you to detect problems and clarify the causes of pain.

What is an MRI of the sacroiliac joints?

What it shows: the condition of the soft tissues and the presence of pathological changes characteristic of:

• inflammation of the spinal cord and vertebrae, including in the initial stages;
• ankylosing spondylitis, when the spinal column looks like a bamboo stick;
• sacroiliitis (the most informative is MRI of the sacroiliac joints with fat suppression);
• neoplasms;
• spinal injuries;
• arthrosis.

Key Benefits of MRI

When examining this zone, CT and X-rays are considered insufficiently informative, therefore MRI is prescribed. The procedure allows you to better determine changes in the structure of the joint, ligaments, tissues and muscles. With the help of the study, the germination of the tumor in the bones of the lower part of the spine and pelvis is clarified.

The procedure is completely safe, it can be repeated several times. The patient's body is affected by a magnetic field, which is safe and does not cause negative consequences. In the course of the study, the difference in tissue density, changes in their physical and chemical state are determined. As a result, it is possible to determine the occurrence of pathology in the early stages. The use of a contrast agent greatly facilitates diagnosis by improving visualization.

Indications for diagnostics

• Suspicion of rheumatism when x-rays are not possible.
• Refinement of information obtained from X-ray examination.
• The presence of symptoms of pathology of the sacroiliac joints and the absence of confirmation of the disease according to the results of radiography and CT.
• Lower back injury, spinal injury.

If there is suspicion of the formation of ankylosing spondylitis and sacroiliitis

It is an effective tool for diagnosing sacroiliitis at the initial stages of development. The use of a tomograph makes it much easier to make a diagnosis at the pre-radiological stages. MRI visualizes swelling of the subchondral bone, changes in the ileosacral joints are visible. Using this method, you can check for exacerbation and remission.

When a patient is diagnosed with osteochondrosis

An informative and accurate method of MRI diagnostics is used for examination in cases of suspected osteochondrosis. With the help of magnetic resonance imaging, the picture of the state of a certain area of ​​the study is clarified. The method allows to effectively diagnose arthritis in the early stages, to determine the presence of edema and pathology in the structure of the joints.

When inflammation occurs in the joints of the lower extremities

The study is effective in diagnosing diseases that are characterized by inflammatory processes in the joints of the lower extremities, especially the ankle. The procedure is prescribed for difficult movement, to determine the appropriateness of the operation.

How is the preparation for diagnosis carried out?

Special preparation for the study is not required. There is no need to limit the intake of medicines, drinks and food. Preparation is required if contrast is to be injected. Preliminary clarification of the presence of allergies, the absence of renal failure and pregnancy in the first trimester.

How is the research done?

Before the procedure, you need to remove all metal objects, including jewelry and piercings, removable dentures. The patient lies on a special movable table, which is rolled up inside the tomograph. During the procedure, it is necessary to lie still in order to obtain high-quality images of the area under study and make a correct diagnosis. The procedure lasts from 30 minutes to 1 hour, the duration depends on the size of the study area and whether contrast has been introduced. The obtained images are issued to the patient on the same day. A specialist opinion on the results of the study is also provided.

Features of the procedure using contrast

Gadolinium is used for contrast studies. With its introduction, a better visualization of inflammatory processes in the joint area is provided. Administer contrast intravenously. The substance is completely excreted from the body after a few hours. Before the introduction of contrast, the presence of allergies is clarified.

Contraindications for the study

The procedure is not performed on patients who have metal stents installed in their body (if the metal is non-magnetic, the procedure can be performed), insulin pumps, pacemakers. Exposure to a magnetic field during an examination may adversely affect the operation of the devices.
Among the contraindications to the procedure with the introduction of contrast:

• pregnancy and lactation;
• liver and kidney failure;
• the presence of an allergy to the injected substance.

MRI of the sacroiliac joints is indicated for the occurrence of such clinical symptoms as persistent pain in the lumbar and pelvic region, swelling, as well as for spinal injuries and a genetic predisposition to ankylosing spondylitis (Bekhterev's disease). This technique is used in the absence of changes or their fuzziness on the radiograph in combination with a pronounced clinical picture. In some cases, MRI of the sacroiliac joints is used when the treatment of a disease diagnosed by radiography (for example, osteochondrosis) is ineffective, as well as to monitor the effectiveness of therapy for Bechterew's disease or other autoimmune diseases.

Contraindications

Absolute contraindications to MRI are pregnancy in the first trimester, magnetically sensitive and metal foreign bodies in the patient's body (hearing aids, vascular clips, pacemakers-defibrillators, metal fragments, traumatological and orthopedic constructions, including the Ilizarov apparatus or steel joint endoprostheses), tattoos, the paint of which contains metal particles. The use of intravenous contrast is contraindicated in persons allergic to gadolinium preparations, severe renal failure, and nursing mothers. The list of relative contraindications to MRI includes severe respiratory or cardiovascular failure, unstable patient condition, mental disorders with increased motor excitability, claustrophobia, pregnancy in the II-III trimesters, the presence of non-ferromagnetic foreign bodies (nerve stimulators, ceramic endoprostheses), body weight over 130-150 kg.

Training

4-6 hours before the MRI of the sacroiliac joints, you must refuse to eat. In the presence of disorders of the motor function of the intestine or during the study on an emergency basis, the patient is given a cleansing enema or laxatives. For children and persons unable to stay in a static position for a long time, medical sedation is performed by a staff anesthesiologist. Immediately before the start of MRI of the sacroiliac joints, it is necessary to remove all metal objects from the body - hairpins, dentures, jewelry. Often the patient is asked to change into a special gown.

Methodology

MRI of the sacroiliac joints is performed using a tomograph. The device looks like a large ring or pipe with thick walls and a hole with a platform inside. After preparation and instruction by the radiologist, the patient lies down on the platform, which is placed inside the magnet. During operation of the device, you can hear a soft clatter or click. Most patients do not experience any somatic sensations inside the tomograph; in rare cases, a feeling of tingling or warmth in the lower abdomen and pelvic area may occur. The total duration of the study is on average 30 minutes. With proper preparation and proper conduct of the procedure, no complications or undesirable consequences are observed; against the background of the use of intravenous contrast, slight dizziness or general weakness is possible.

The results of MRI of the sacroiliac joints in most clinics are issued within an hour after the end of the procedure. This may be the conclusion of a radiology doctor and a description of the images on paper, a CD with all the slices of the images of the area under study and their printed copies. MRI of the sacroiliac joints allows the attending specialist to establish traumatic injuries of the iliac bones and sacrum, deformity, narrowing or absence of joint spaces (sacroiliitis, Bechterew's disease), the presence of exostoses, osteophytes, tumors, taking into account their localization, structure and size, calcification of the articular-ligamentous apparatus.

The sacroiliac joint is a paired joint that connects the pelvic ilium to the sacrum of the spine. Pathologies of this joint often cause excruciating pain in the spine, hip or leg. The pain spreads through the muscles and may be "wandering". The destruction of the articulation itself can cause degeneration of the structures of the spine, infringement of the sciatic nerve. X-ray in such cases is not informative, because the pictures do not show changes. To accurately establish the diagnosis, you need to do an MRI of the sacroiliac joints.

What is tomography. MRI is the most informative method for diagnosing the articular apparatus and all its structures: cartilage, nerves, muscles, ligaments, joint capsule. The principle of operation of the tomograph is based on scanning tissues in an electromagnetic field. The apparatus consists of a powerful permanent magnet and gradient coils, a scanner and a computer. It is programmed to scan any part of the body and process the information flow for reconstruction into a 3D image.

You can do an MRI of the pelvis, spine, or, for example, the knee joints. The contrast image will show the anatomical boundaries of the organs, their sizes, outlines and internal structures. Speaking figuratively, MRI allows you to see any part of the body in a section, and in several planes. For example, MRI of the pelvic bones makes it possible to create a series of images from different angles of the pelvis in section, which will clearly show any pathology and changes: a fissure, a fracture, osteomyelitis, necrosis, cancer.

What is the examination for? The lower back, aching for the weather, pain in the hip area when walking, cramps in the abdomen are symptoms of several dozen diseases for which it is impossible to establish a diagnosis. And if a patient comes with complaints that “it shoots in the lower back, then the kidneys hurt, then the legs are buzzing,” then the problem turns into an equation with many unknowns. In order not to treat non-existent sciatica or pyelonephritis (which the patient may have, but has nothing to do with pain), you need to undergo an MRI of the sacroiliac joints.

These joints are really often affected and become a source of problems. The reason may be:

• arthritis (inflammation of the structures of the articular apparatus);
• arthrosis - degenerative-dystrophic changes (destruction);
• articulation dysfunction with impaired motor mobility (abnormal hypermobility or blockage);
• damage to ligaments and muscles;
• joint infection, etc.

The complex structure and heavy load on these joints makes them very vulnerable. They are easily damaged by injuries, for example, when falling during winter ice.

Indications for MRI of the sacroiliac joints

• malformations, congenital anomalies;
• pain in the legs, in the buttocks, pelvis, lower back, sometimes in the knee and below;
• trauma;
• limitation of mobility or instability (the patient cannot raise the straight leg or even pull the bent leg to the stomach);
• crunch, clicks in the joint;
• inflammation, swelling
• suspected tumor.