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sacroiliac joint

Derek P Lindsey, Ali Kiapour, Scott A Yerby, Vijay K Goel
AIM: To analyze how various implants placement variables affect sacroiliac (SI) joint range of motion. METHODS: An experimentally validated finite element model of the lumbar spine and pelvis was used to simulate a fusion of the SI joint using various placement configurations of triangular implants (iFuse Implant System® ). Placement configurations were varied by changing implant orientation, superior implant length, and number of implants. The range of motion of the SI joint was calculated using a constant moment of 10 N-m with a follower load of 400 N...
March 18, 2018: World Journal of Orthopedics
Taolin Fang, Glenn S Russo, Gregory D Schroeder, Christopher K Kepler
Achieving an osseous fusion across the lumbosacral spine is still challenging in spine surgery. For the long multisegmental fusion surgery, it is crucial to build a robust and substantial foundation, which sometimes necessitates the distal spinal fixation to the pelvis. The pelvic fixation technique involves advancing the screw through the alar, thereby providing more purchase across the sacroiliac joint and into the ilium. The S2 alar iliac screws can obtain immediate stability and proper biomechanical strength of constructs...
March 16, 2018: Clinical Spine Surgery
Yiqiu Zhang, Beilei Li, Haojun Yu, Jun Hou, Hongcheng Shi
Ankylosing spondylitis (AS) is a form of arthritis that affects the spine, the sacroiliac joints, and sometimes the hips and shoulders. Andersson lesion (AL), was first described by Andersson in 1937 as a destructive vertebral body and discovertebral portion of the spine in AS. In this case, we report a 50 years old man with medical history of AS diagnosed AL by fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT).
March 20, 2018: Hellenic Journal of Nuclear Medicine
Tomasz Sipko, Adam Paluszak, Agnieszka Siudy
OBJECTIVE: This study aimed to evaluate the effect of sacroiliac joint (SIJ) mobilization and/or self-mobilization on the level of soft tissue pain threshold in 21- to 23-year-old asymptomatic women (n = 20). METHODS: The FPIX Wagner Algometer was applied to compute the pressure pain threshold (PPT) over the right and left side of the iliolumbar ligament and lumbar erector spinae (L3). Measurements were taken of the right SIJ before and after a randomized protocol of oscillating mobilization, self-mobilization, and placebo treatment...
March 2018: Journal of Manipulative and Physiological Therapeutics
Sovira Tan, Michael M Ward
PURPOSE OF REVIEW: Computed tomography (CT) is increasingly being used in ankylosing spondylitis (AS) for imaging the spine and sacroiliac joint (SIJ). We review new insights to diagnosis and evaluation revealed by the use of CT. RECENT FINDINGS: Studies using low-dose CT in AS to detect syndesmophytes can image the entire spine, but semiquantitative scoring of the scans by human readers decreases the reliability and validity of this method. The thoracic spine is the segment most involved with syndesmophytes...
March 13, 2018: Current Opinion in Rheumatology
Mark P Sykes, Louise Hamilton, Colin Jones, Karl Gaffney
Objective: Acute anterior uveitis (AAU) is the most common extra-articular manifestation of axial spondyloarthritis (axSpA). In this study, patients presenting with AAU were evaluated clinically and with MRI in order to estimate the prevalence of axSpA. Methods: Consecutive patients presenting to a university teaching hospital between February 2014 and March 2015 with AAU were invited to participate. Those with a history of chronic back pain (CBP) beginning <45 years were evaluated clinically and with MRI of thoracolumbar spine and sacroiliac joints...
2018: RMD Open
Gesa Bakker, Joerg Hattingen, Hartmut Stuetzer, Joerg Isenberg
OBJECTIVE: The diagnosis of insufficiency fractures of the sacrum in an elder population increases annually. Fractures show very different morphology. We aimed to classify sacral insufficiency fractures according to the position of cortical break and possible need for intervention. METHODS: Between January 1, 2008 and December 31, 2014, all patients with a proven fracture of the sacrum following a low-energy or an even unnoticed trauma were prospectively registered : 117 females and 13 males...
March 2018: Journal of Korean Neurosurgical Society
E Calle, L A González, C H Muñoz, D Jaramillo, A Vanegas, G Vásquez
Systemic lupus erythematosus (SLE) patients are at higher risk of developing opportunistic infections such as tuberculosis (TB), especially extrapulmonary forms like osteoarticular TB, compared to the general population. However, tuberculous sacroiliitis has been scarcely reported in these patients. We present a 34-year-old woman with SLE who developed articular tuberculosis simultaneously affecting the right sacroiliac joint and the left knee. The patient was successfully treated with antituberculosis therapy for nine months...
January 1, 2018: Lupus
Stephen R Thompson, Isabel S Y Lee, Susan Carroll, Sarah Bishop, Philip Douglas, Francis Lam, Chris Brown, Janet Williams, David Goldstein
BACKGROUND: Loco-regional failure is the predominant cause of death in anal squamous cell carcinoma. We assessed patterns of loco-regional recurrence to determine the impact of radiotherapy (RT) volumes on patient outcome. METHODS: Retrospective clinical study, including patients treated curatively with RT or chemo-radiotherapy between 1994 and 2007. RT fields/volumes were reviewed and compared with patterns of failure. Patients were classified as having whole pelvic radiotherapy (WPRT) if RT extended to L5/S1 or lower pelvic radiotherapy (LPRT) if it extended to the lower sacroiliac joints or below...
March 7, 2018: ANZ Journal of Surgery
Janneke de Winter, Manouk de Hooge, Marleen van de Sande, Henriëtte de Jong, Lonneke van Hoeven, Anoek de Koning, Inger Jorid Berg, Roberta Ramonda, Dominique Baeten, Désirée van der Heijde, Angelique Weel, Robert Landewé
OBJECTIVE: To compare MRI of the sacroiliac joints (MRI-SI) of healthy, symptomless individuals and those with known mechanical strain acting upon SI joints to axial spondyloarthritis (axSpA) and chronic back pain (CBP) patients. METHODS: Three trained, calibrated and blinded readers randomly scored MRI-SI of 172 subjects: 47 healthy individuals without current/past back pain; 47 axSpA patients from the SPondyloArthritis Caught Early (SPACE) cohort (with a previously confirmed positive MRI-SI); 47 CBP controls (irrespective of MRI-SI results) from the SPACE cohort; 7 women with postpartum back pain; and 24 frequent runners...
March 7, 2018: Arthritis & Rheumatology
Amin Joukar, Anoli Shah, Ali Kiapour, Ardalan Seyed Vosoughi, Bradley Duhon, Anand K Agarwal, Hossein Elgafy, Nabil Ebraheim, Vijay K Goel
STUDY DESIGN: The comparison of sacroiliac joint (SIJ) angular motions, pelvis ligaments strain, load sharing, and stress distribution across the joint for male and female spine-pelvis-femur models using finite element analysis. OBJECTIVE: To quantify biomechanical parameters at SIJ for all motions for both male and female models. SUMMARY OF BACKGROUND DATA: SIJ has been recognized as a main source of pain in 13% to 30% of patients with low back pain...
March 5, 2018: Spine
Marco Aurélio N Added, Diego G de Freitas, Karina T Kasawara, Robroy L Martin, Thiago Y Fukuda
Study design: Case series. Background and purpose: The literature has emphasized the use of exercise as an intervention for individuals with lumbopelvic pain. However, there is limited information to guide clinicians in exercise selection for those with sacroiliac (SI) joint dysfunction. Altered function of the gluteus maximus has been found in those with SI joint dysfunction. The objective of this case series was to assess the effectiveness of an exercise program directed at increasing gluteus maximus strength in those with clinical tests positive for SI joint dysfunction...
February 2018: International Journal of Sports Physical Therapy
Yushane C Shih, Brian P Beaubien, Qingshan Chen, Jonathan N Sembrano
BACKGROUND CONTEXT: Fusion typically consists of joint preparation, grafting and rigid fixation. Fusion has been successfully used to treat symptomatic disruptions of the SIJ and degenerative sacroiliitis using purpose-specific, threaded implants. The biomechanical performance of these systems is important but has not been studied. PURPOSE: To compare two techniques for placing primary (12.5mm) and secondary (8.5mm) implants across the SIJ. STUDY DESIGN: A human cadaveric biomechanical study of sacroiliac joint (SIJ) fixation...
February 23, 2018: Spine Journal: Official Journal of the North American Spine Society
Cédric Lukas, Catherine Cyteval, Maxime Dougados, Ulrich Weber
Recognition of axial spondyloarthritis (SpA) remains challenging, as no unique reference standard is available to ascertain diagnosis. Imaging procedures have been used for long in the field, in particular pelvic radiography, to capture structural changes evocative of sacroiliitis, the key feature in SpA. The introduction of MRI of the sacroiliac joints (SIJs) has led to a major shift in recognition of the disorder. MRI has been shown to detect the initial inflammatory processes, in particular osteitis depicted by bone marrow oedema, even in patients having not yet developed structural lesions...
2018: RMD Open
Kwi Young Kang, Hye Yeon Goo, Sung-Hwan Park, Yeon Sik Hong
Objectives: To compare the trabecular bone score (TBS) between patients with axial spondyloarthritis (axSpA) and matched normal controls and identify risk factors associated with a low TBS. Methods: TBS and BMD were assessed in the two groups (axSpA and control) using DXA. Osteoporosis risk factors and inflammatory markers were also assessed. Disease activity and radiographic progression in the sacroiliac joint and spine were evaluated in the axSpA group. Multivariate linear regression analysis was performed to identify risk factors associated with TBS...
March 1, 2018: Rheumatology
Yukai Huang, Weiming Deng, Shaoling Zheng, Fan Feng, Zhixiang Huang, Qidang Huang, Xin Guo, Zhengping Huang, Xuechang Huang, Xia Pan, Tianwang Li
BACKGROUND: Axial spondyloarthritis (axSpA) is a progressive, chronic, inflammatory skeletal disorder affecting the spine and sacroiliac joints. Many studies have shown that neutrophils, lymphocytes, monocytes, platelets, and red blood cells (RBCs) play important roles in the inflammatory process of axSpA. Neutrophils to lymphocytes ratio (NLR) and red blood cell distribution width (RDW) have been reported to be simple and inexpensive markers to indicate the disease activity of axSpA...
February 19, 2018: International Immunopharmacology
A de Koning, J W Schoones, D van der Heijde, F A van Gaalen
Axial spondyloarthritis (axSpA) is a common inflammatory arthritis of the sacroiliac joints and the spine. The best-known and most studied form of axSpA is ankylosing spondylitis. In this review, we provide a brief overview of the pathophysiology of axSpA. In addition, we performed a quantitative text analysis of reviews on the pathogenesis of axSpA published in the last ten years to establish the current consensus in various fields of research into the pathogenesis of axSpA. There appears to be broad consensus on genetic risk factors and the involvement of the immune system in the initiation phase of the disease although little consensus was found on which specific immune cells drive disease...
February 20, 2018: European Journal of Clinical Investigation
Simon Krabbe, Mikkel Østergaard, Iris Eshed, Inge J Sørensen, Bente Jensen, Jakob M Møller, Lone Balding, Ole R Madsen, Karsten Asmussen, Grith Eng, Niklas R Jørgensen, Susanne J Pedersen
OBJECTIVE: To investigate whether adalimumab (ADA) reduces whole-body (WB-) magnetic resonance imaging (MRI) indices for inflammation in the entheses, peripheral joints, sacroiliac joints, spine, and the entire body in patients with axial spondyloarthritis (axSpA). METHODS: An investigator-initiated, randomized, placebo-controlled, double-blinded 48-week followup trial included 49 patients with axSpA, who had Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 4...
February 15, 2018: Journal of Rheumatology
Ulrich Weber, Anne Grethe Jurik, Anna Zejden, Ejnar Larsen, Steen Hylgaard Jørgensen, Kaspar Rufibach, Christian Schioldan, Søren Schmidt-Olsen
OBJECTIVE: Low grade bone marrow edema (BME) was reported in the sacroiliac joints (SIJ) of 25% of healthy individuals and mechanical back pain patients, challenging the imaging discrimination from early spondyloarthritis (SpA). It is unknown whether stress injury in competition sports may trigger BME. We explored frequency and anatomical distribution of SIJ MRI lesions in recreational and elite athletes. METHODS: After pre-test calibration, semicoronal SIJ MRI scans of 20 recreational runners (RR) before/after running and 22 elite ice-hockey players (IP) were assessed by 3 blinded readers for BME and structural lesions using an SIJ quadrant-based module...
February 12, 2018: Arthritis & Rheumatology
Christopher Ritchlin
The inclusion of the imaging arm in the Assessment of SpondyloArthritis International Society (ASAS) Classification Criteria catalyzed a transformation in the classification, diagnosis and treatment of axial SpA (1). A majority of patients with inflammatory back pain do not demonstrate radiographic changes and some were classified as undifferentiated spondyloarthritis (SpA) based on associated clinical features. (2). This nebulous classification was confusing at best and not recognized by many clinicians. As a result, the therapeutic approach to this group of patients was not well-defined...
February 12, 2018: Arthritis & Rheumatology
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