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Skeletal Radiology
Published in: Skeletal Radiology 3/2020

01-03-2020 | Magnetic Resonance Imaging | Scientific Article

CT-guided transarticular biopsy of the sacroiliac joint: Technique and histomorphological results. A preliminary study

Authors: Niels Egund, Flemming Brandt Sørensen, René Østgård, Anne Gitte Loft, Lene Warner Thorup Boel, Anne Grethe Jurik

Published in: Skeletal Radiology | Issue 3/2020

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Abstract

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.
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Metadata
Title
CT-guided transarticular biopsy of the sacroiliac joint: Technique and histomorphological results. A preliminary study
Authors
Niels Egund
Flemming Brandt Sørensen
René Østgård
Anne Gitte Loft
Lene Warner Thorup Boel
Anne Grethe Jurik
Publication date
01-03-2020
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 3/2020
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-019-03305-x

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