MRI-guided sacroiliac joint injections in children and adults: current practice and future developments

Danoob Dalili; Amanda Isaac; Jan Fritz

doi:10.1007/s00256-022-04161-y

MRI-guided sacroiliac joint injections in children and adults: current practice and future developments

Danoob Dalili, Amanda Isaac, Jan Fritz^*

^*Corresponding author for this work

Biomedical Engineering Department

Research output: Contribution to journal › Review article › peer-review

6 Citations (Scopus)

Abstract

Common etiologies of low back pain include degenerative arthrosis and inflammatory arthropathy of the sacroiliac joints. The diagnostic workup revolves around identifying and confirming the sacroiliac joints as a pain generator. Diagnostic sacroiliac joint injections often serve as functional additions to the diagnostic workup through eliciting a pain response that tests the hypothesis that the sacroiliac joints do or do not contribute to the patient’s pain syndrome. Therapeutic sacroiliac joint injections aim to provide medium- to long-term relief of symptoms and reduce inflammatory activity and, ultimately, irreversible structural damage. Ultrasonography, fluoroscopy, computed tomography, and magnetic resonance imaging (MRI) may be used to guide sacroiliac joint injections. The populations that may benefit most from MRI-guided sacroiliac joint procedures include children, adolescents, adults of childbearing age, and patients receiving serial injections due to the ability of interventional MRI to avoid radiation exposure. Most clinical wide-bore MRI systems can be used for MRI-guided sacroiliac joint injections. Turbo spin echo pulse sequences optimized for interventional needle display visualize the needle tip with an error margin of < 1 mm or less. Published success rates of intra-articular sacroiliac joint drug delivery with MRI guidance range between 87 and 100%. The time required for MR-guided sacroiliac joint injections in adults range between 23–35 min and 40 min in children. In this article, we describe techniques for MRI-guided sacroiliac joint injections, share our practice of incorporating interventional MRI in the care of patients with sacroiliac joint mediated pain, discuss the rationales, benefits, and limitations of interventional MRI, and conclude with future developments.

Original language	English
Journal	Skeletal Radiology
DOIs	https://doi.org/10.1007/s00256-022-04161-y
Publication status	E-pub ahead of print - 25 Aug 2022

Keywords

Computed tomography
Imaging guidance
Injection
Magnetic resonance
Sacroiliac joints

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10.1007/s00256-022-04161-y

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title = "MRI-guided sacroiliac joint injections in children and adults: current practice and future developments",

abstract = "Common etiologies of low back pain include degenerative arthrosis and inflammatory arthropathy of the sacroiliac joints. The diagnostic workup revolves around identifying and confirming the sacroiliac joints as a pain generator. Diagnostic sacroiliac joint injections often serve as functional additions to the diagnostic workup through eliciting a pain response that tests the hypothesis that the sacroiliac joints do or do not contribute to the patient{\textquoteright}s pain syndrome. Therapeutic sacroiliac joint injections aim to provide medium- to long-term relief of symptoms and reduce inflammatory activity and, ultimately, irreversible structural damage. Ultrasonography, fluoroscopy, computed tomography, and magnetic resonance imaging (MRI) may be used to guide sacroiliac joint injections. The populations that may benefit most from MRI-guided sacroiliac joint procedures include children, adolescents, adults of childbearing age, and patients receiving serial injections due to the ability of interventional MRI to avoid radiation exposure. Most clinical wide-bore MRI systems can be used for MRI-guided sacroiliac joint injections. Turbo spin echo pulse sequences optimized for interventional needle display visualize the needle tip with an error margin of < 1 mm or less. Published success rates of intra-articular sacroiliac joint drug delivery with MRI guidance range between 87 and 100%. The time required for MR-guided sacroiliac joint injections in adults range between 23–35 min and 40 min in children. In this article, we describe techniques for MRI-guided sacroiliac joint injections, share our practice of incorporating interventional MRI in the care of patients with sacroiliac joint mediated pain, discuss the rationales, benefits, and limitations of interventional MRI, and conclude with future developments.",

keywords = "Computed tomography, Imaging guidance, Injection, Magnetic resonance, Sacroiliac joints",

author = "Danoob Dalili and Amanda Isaac and Jan Fritz",

note = "Funding Information: This work was in part funded by National Institutes of Health grants R01 EB025179 and R01 CA118371. Publisher Copyright: {\textcopyright} 2022, The Author(s), under exclusive licence to International Skeletal Society (ISS).",

year = "2022",

month = aug,

day = "25",

doi = "10.1007/s00256-022-04161-y",

language = "English",

journal = "Skeletal Radiology",

issn = "0364-2348",

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TY - JOUR

T1 - MRI-guided sacroiliac joint injections in children and adults

T2 - current practice and future developments

AU - Dalili, Danoob

AU - Isaac, Amanda

AU - Fritz, Jan

N1 - Funding Information: This work was in part funded by National Institutes of Health grants R01 EB025179 and R01 CA118371. Publisher Copyright: © 2022, The Author(s), under exclusive licence to International Skeletal Society (ISS).

PY - 2022/8/25

Y1 - 2022/8/25

N2 - Common etiologies of low back pain include degenerative arthrosis and inflammatory arthropathy of the sacroiliac joints. The diagnostic workup revolves around identifying and confirming the sacroiliac joints as a pain generator. Diagnostic sacroiliac joint injections often serve as functional additions to the diagnostic workup through eliciting a pain response that tests the hypothesis that the sacroiliac joints do or do not contribute to the patient’s pain syndrome. Therapeutic sacroiliac joint injections aim to provide medium- to long-term relief of symptoms and reduce inflammatory activity and, ultimately, irreversible structural damage. Ultrasonography, fluoroscopy, computed tomography, and magnetic resonance imaging (MRI) may be used to guide sacroiliac joint injections. The populations that may benefit most from MRI-guided sacroiliac joint procedures include children, adolescents, adults of childbearing age, and patients receiving serial injections due to the ability of interventional MRI to avoid radiation exposure. Most clinical wide-bore MRI systems can be used for MRI-guided sacroiliac joint injections. Turbo spin echo pulse sequences optimized for interventional needle display visualize the needle tip with an error margin of < 1 mm or less. Published success rates of intra-articular sacroiliac joint drug delivery with MRI guidance range between 87 and 100%. The time required for MR-guided sacroiliac joint injections in adults range between 23–35 min and 40 min in children. In this article, we describe techniques for MRI-guided sacroiliac joint injections, share our practice of incorporating interventional MRI in the care of patients with sacroiliac joint mediated pain, discuss the rationales, benefits, and limitations of interventional MRI, and conclude with future developments.

AB - Common etiologies of low back pain include degenerative arthrosis and inflammatory arthropathy of the sacroiliac joints. The diagnostic workup revolves around identifying and confirming the sacroiliac joints as a pain generator. Diagnostic sacroiliac joint injections often serve as functional additions to the diagnostic workup through eliciting a pain response that tests the hypothesis that the sacroiliac joints do or do not contribute to the patient’s pain syndrome. Therapeutic sacroiliac joint injections aim to provide medium- to long-term relief of symptoms and reduce inflammatory activity and, ultimately, irreversible structural damage. Ultrasonography, fluoroscopy, computed tomography, and magnetic resonance imaging (MRI) may be used to guide sacroiliac joint injections. The populations that may benefit most from MRI-guided sacroiliac joint procedures include children, adolescents, adults of childbearing age, and patients receiving serial injections due to the ability of interventional MRI to avoid radiation exposure. Most clinical wide-bore MRI systems can be used for MRI-guided sacroiliac joint injections. Turbo spin echo pulse sequences optimized for interventional needle display visualize the needle tip with an error margin of < 1 mm or less. Published success rates of intra-articular sacroiliac joint drug delivery with MRI guidance range between 87 and 100%. The time required for MR-guided sacroiliac joint injections in adults range between 23–35 min and 40 min in children. In this article, we describe techniques for MRI-guided sacroiliac joint injections, share our practice of incorporating interventional MRI in the care of patients with sacroiliac joint mediated pain, discuss the rationales, benefits, and limitations of interventional MRI, and conclude with future developments.

KW - Computed tomography

KW - Imaging guidance

KW - Injection

KW - Magnetic resonance

KW - Sacroiliac joints

UR - http://www.scopus.com/inward/record.url?scp=85137052615&partnerID=8YFLogxK

U2 - 10.1007/s00256-022-04161-y

DO - 10.1007/s00256-022-04161-y

M3 - Review article

C2 - 36006462

AN - SCOPUS:85137052615

SN - 0364-2348

JO - Skeletal Radiology

JF - Skeletal Radiology

ER -

MRI-guided sacroiliac joint injections in children and adults: current practice and future developments

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Keywords

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