从影像学角度看骶髂关节病变的鉴别诊断  

Differential diagnosis of sacroiliac joint lesions from an imaging perspective

作　　者：冀肖健 朱剑 JI Xiao-jian;ZHU Jian(Department of Rheumatology and Immunology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第一医学中心风湿免疫科,北京100853

出　　处：《中国实用内科杂志》2024年第12期1011-1017,共7页Chinese Journal of Practical Internal Medicine

基　　金：北京市自然科学基金(L242143);解放军总医院青年自主创新科学基金项目(22QNFC139)。

摘　　要：骶髂关节炎是中轴型脊柱关节炎(axSpA)的重要临床病理表现,影像学检查在骶髂关节炎的诊断中起着至关重要的作用。MRI技术能够早期发现骶髂关节的炎症改变,有助于早期诊断axSpA并制定治疗方案。然而,骶髂关节病变并非axSpA所特有,其鉴别诊断需要考虑多种病因,如感染性、退行性、创伤性以及其他炎症性疾病,这些病因在影像学上也可能呈现类似的特征。此外,健康人、运动员和产后女性也可出现骶髂关节骨髓水肿。因此,准确的鉴别诊断对于避免误诊和漏诊至关重要。Sacroilitis is most commonly seen in axial spondyloarthritis(axSpA).Imaging plays a crucial role in the diagnosis and follow-up of sacroilitis.Techniques such as MRI and CT can detect early inflammatory changes in the sacroiliac joints,aiding in the timely diagnosis of axSpA and the development of individualized treatment plans.However,sacroilitis is not exclusive to axSpA,and its differential diagnosis requires consideration of multiple potential causes,including infectious,degenerative,traumatic,and other inflammatory conditions,which may present with similar imaging features.In addition,bone marrow edema of sacroiliac joints may be present in healthy people,athletes and postpartum women.In addition,,sacroiliac joint bone marrow edema can also occur in healthy individuals,athletes,and postpartum women.Therefore,accurate differentiation is essential to avoid misdiagnosis and missed diagnoses.

关 键 词：骶髂关节病变 脊柱关节炎 鉴别诊断 

分 类 号：R593.23[医药卫生—内科学]