TY - JOUR
T1 - CT-guided transarticular biopsy of the sacroiliac joint
T2 - Technique and histomorphological results. A preliminary study
AU - Egund, Niels
AU - Sørensen, Flemming Brandt
AU - Østgård, René
AU - Loft, Anne Gitte
AU - Boel, Lene Warner Thorup
AU - Jurik, Anne Grethe
PY - 2020/3
Y1 - 2020/3
N2 - 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.
AB - 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.
KW - Biopsy
KW - Computed tomography
KW - Histopathology
KW - Sacroiliac joints
KW - Spondyloarthritis
UR - https://www.scopus.com/pages/publications/85071762300
U2 - 10.1007/s00256-019-03305-x
DO - 10.1007/s00256-019-03305-x
M3 - Journal article
C2 - 31485679
AN - SCOPUS:85071762300
SN - 0364-2348
VL - 49
SP - 453
EP - 460
JO - Skeletal Radiology
JF - Skeletal Radiology
IS - 3
ER -