The immature sacroiliac joints on cross-sectional imaging: developmental anatomy and diagnostic pitfalls

Jurik AG, Herregods N. The sacroiliac joint across ages - what is normal? Ther Adv Musculoskelet Dis. 2024;16:1759720X241241126.

Article  PubMed  PubMed Central  Google Scholar 

Herregods N, Jans LBO, Chen M, et al. Normal subchondral high T2 signal on MRI mimicking sacroiliitis in children: frequency, age distribution, and relationship to skeletal maturity. Eur Radiol. 2021;31:3498–507.

Article  CAS  PubMed  Google Scholar 

Herregods N, Lambert RGW, Schiettecatte E, et al. Blurring and irregularity of the subchondral cortex in pediatric sacroiliac joints on T1 images: incidence of normal findings that can mimic erosions. Arthritis Care Res (Hoboken). 2023;75:190–7.

Article  PubMed  Google Scholar 

Chauvin NA, Xiao R, Brandon TG, et al. MRI of the sacroiliac joint in healthy children. AJR Am J Roentgenol. 2019;212:1303–9.

Article  PubMed  Google Scholar 

Weiss PF, Roth J. Juvenile- versus adult-onset spondyloarthritis: similar, but different. Rheum Dis Clin North Am. 2020;46:241–57.

Article  PubMed  Google Scholar 

De Leeuw A, Cherkaoui Jaouad R, Kamoun M, Abidi S, Michelin P, Cotten A. When it is not sacroiliitis. Skeletal Radiol. 2025;54:2433–42.

Article  PubMed  PubMed Central  Google Scholar 

Bollow M, Braun J, Kannenberg J, et al. Normal morphology of sacroiliac joints in children: magnetic resonance studies related to age and sex. Skeletal Radiol. 1997;26:697–704.

Article  CAS  PubMed  Google Scholar 

Coudert P, Dubé-Cyr R, Chaumoitre K, et al. Sacroiliac joint morphologic changes from infancy to adulthood. Spine J. 2019;19:1730–8.

Article  PubMed  Google Scholar 

Zejden A, Jurik AG. Anatomy of the sacroiliac joints in children and adolescents by computed tomography. Pediatr Rheumatol Online J. 2017;15:82.

Article  PubMed  PubMed Central  Google Scholar 

Vereecke E, Morbée L, Laloo F, et al. Anatomical variation of the sacroiliac joints: an MRI study with synthetic CT images. Insights Imaging. 2023;14:30.

Article  PubMed  PubMed Central  Google Scholar 

Herregods N, Maksymowych WP, Jans L, et al. Atlas of MRI findings of sacroiliitis in pediatric sacroiliac joints to accompany the updated preliminary OMERACT pediatric JAMRIS (juvenile idiopathic arthritis MRI score) scoring system: part I: active lesions. Semin Arthritis Rheum. 2021;51:1089–98.

Article  CAS  PubMed  Google Scholar 

Herregods N, Maksymowych WP, Jans L, et al. Atlas of MRI findings of sacroiliitis in pediatric sacroiliac joints to accompany the updated preliminary OMERACT pediatric JAMRIS (juvenile idiopathic arthritis MRI score) scoring system: part II: structural damage lesions. Semin Arthritis Rheum. 2021;51:1099–107.

Article  CAS  PubMed  Google Scholar 

Lambert RGW, Baraliakos X, Bernard SA, et al. Development of international consensus on a standardised image acquisition protocol for diagnostic evaluation of the sacroiliac joints by MRI: an ASAS-SPARTAN collaboration. Ann Rheum Dis. 2024;83:1628–35.

Article  PubMed  PubMed Central  Google Scholar 

Özgen A. The value of the T2-weighted multipoint Dixon sequence in MRI of sacroiliac joints for the diagnosis of active and chronic sacroiliitis. AJR Am J Roentgenol. 2017;208:603–8.

Article  PubMed  Google Scholar 

Athira R, Cannane S, Thushara R, Poyyamoli S, Nedunchelian M. Diagnostic accuracy of standalone T2 Dixon sequence compared with conventional MRI in sacroiliitis. Indian J Radiol Imaging. 2022;32:314–23.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Chien CPY, Lee VKH, Chung HY, Lau V. The effect of subchondral oedema in T2-weighted Dixon MRI sequence evaluation of sacroiliac joint erosion in axial spondyloarthropathy. Clin Radiol. 2022;77:e783–8.

Article  CAS  PubMed  Google Scholar 

Chong LR, Lee K, Sim FY. 3D MRI with CT-like bone contrast - an overview of current approaches and practical clinical implementation. Eur J Radiol. 2021;143:109915.

Article  PubMed  Google Scholar 

Afsahi AM, Ma Y, Jang H, et al. Ultrashort echo time magnetic resonance imaging techniques: met and unmet needs in musculoskeletal imaging. J Magn Reson Imaging. 2022;55:1597–612.

Article  PubMed  Google Scholar 

Johnson B, Alizai H, Dempsey M. Fast field echo resembling a CT using restricted echo-spacing (FRACTURE): a novel MRI technique with superior bone contrast. Skeletal Radiol. 2021;50:1705–13.

Article  PubMed  Google Scholar 

Jans LBO, Chen M, Elewaut D, et al. MRI-based synthetic CT in the detection of structural lesions in suspected sacroiliitis: comparison with MRI. Radiology. 2021;298(2):343–9.

Article  PubMed  Google Scholar 

Wolharn L, Guggenberger R, Higashigaito K, et al. Detailed bone assessment of the sacroiliac joint in a prospective imaging study: comparison between computed tomography, zero echo time, and black bone magnetic resonance imaging. Skeletal Radiol. 2022;51:2307–15.

Article  PubMed  PubMed Central  Google Scholar 

Schiettecatte E, Vereecke E, Jaremko JL, et al. MRI-based synthetic CT for assessment of the bony elements of the sacroiliac joints in children. Insights Imaging. 2024;15(1):53.

Article  PubMed  PubMed Central  Google Scholar 

Aydıngöz Ü, Yıldız AE, Ergen FB. Zero echo time musculoskeletal MRI: technique, optimization, applications, and pitfalls. Radiographics. 2022;42:1398–414.

Article  PubMed  Google Scholar 

Herregods N, Dehoorne J, Jaremko J, et al. Diagnostic value of MRI of the sacroiliac joints in juvenile spondyloarthritis. J Belg Soc Radiol. 2016;100:95.

Article  PubMed  PubMed Central  Google Scholar 

Nozaki T, Tsujioka Y, Sugimoto H, et al. Pearls and pitfalls in imaging of axial spondyloarthritis for rheumatologists. Mod Rheumatol. 2025;35:612–25.

Article  PubMed  Google Scholar 

Saifuddin A, Tyler P, Rajakulasingam R. Imaging of bone marrow pitfalls with emphasis on MRI. Br J Radiol. 2023;96:20220063.

Article  PubMed  Google Scholar 

Navallas M, Ares J, Beltrán B, Lisbona MP, Maymó J, Solano A. Sacroiliitis associated with axial spondyloarthropathy: new concepts and latest trends. Radiographics. 2013;33:933–56.

Article  PubMed  Google Scholar 

Lambert RG, Bakker PA, van der Heijde D, et al. Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group. Ann Rheum Dis. 2016;75:1958–63.

Article  PubMed  Google Scholar 

You SK, Lee HJ, Lee JE, Kim J, Lee SM, Cho HH. Analysis of the sacroiliac joint vacuum phenomenon in paediatric patients. Br J Radiol. 2016;89:20160298.

Article  PubMed  PubMed Central  Google Scholar 

Doğan E, Aydoğmuş H, Aydoğmuş S. An omitted radiological finding in the pediatric age group: physiological sacroiliac joint vacuum normal variant. Spartan Med Res J. 2021;6:27361.

Article  PubMed  PubMed Central  Google Scholar 

Herregods N, Jans LBO, Paschke J, et al. Magnetic resonance imaging findings in the normal pediatric sacroiliac joint space that can simulate disease. Pediatr Radiol. 2021;51:2530–8.

Article  PubMed  Google Scholar 

Orr KE, Andronikou S, Bramham MJ, Holjar-Erlic I, Menegotto F, Ramanan AV. Magnetic resonance imaging of sacroiliitis in children: frequency of findings and interobserver reliability. Pediatr Radiol. 2018;48:1621–8.

Article  PubMed  PubMed Central  Google Scholar 

Morbée L, Vereecke E, Laloo F, Chen M, Herregods N, Jans LBO. Common incidental findings on sacroiliac joint MRI: added value of MRI-based synthetic CT. Eur J Radiol. 2023;158:110651.

Article  PubMed 

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