4/17/2024 0 Comments Normal xray hip 14 years old![]() Axial spine reformats, including the SIJ, with a slice thickness of 1 mm and an increment of 0.5 mm, using a bony reconstruction filter D, were routinely performed and post-processed at a Philips IntelliSpace workstation with software version 6.0 for reconstructions of the SIJ. A post-contrast CT examination of the thorax, abdomen and pelvis was performed using a beam collimation of 0.625 mm, slice thickness of 2 mm, increment 1 mm, kV 100–140 and mAs 100–350 appropriately adjusted for patient size and shape. One girl was examined twice: at the age of 13 years and at the age of 15 years.Īll patients were examined in supine position using a 64-slice Philips Brilliance CT scanner (USA, Cleveland), according to the standard department guidelines. In total, 124 patients aged 9 months – <18 years (mean age 11 years 8 months), 57 girls and 67 boys, were included in our study. Exclusion criteria: Traumatic skeletal and/or organ lesions in the chest, abdomen, pelvis and spine, changes in the SIJ suggestive of sacroiliitis, previous spine or pelvic surgery, CT reconstructions in a bony setting not including the whole SIJ (Fig. Inclusion criteria to our study were: Age below 18 years and no CT detectable traumatic changes in the spine, pelvis, abdomen and chest. They all underwent CT scanning encompassing the head, neck, chest, abdomen and pelvis. A total of 194 juvenile patients met our trauma team activation criteria according to the international ABCDE-system having a score ≥ 2 and the indication for total-body CT used by Treskes et al. The study population comprised patients selected from a local trauma database at our hospital between January 2012 and August 2016. The study was designed as a retrospective analysis conducted at the Department of Radiology, Aarhus University Hospital, Denmark. The purpose of this study was to analyze the normal osseous anatomy of the SIJ in children and adolescents using current multislice CT technique. A total of 25 juvenile individuals were examined by single slice CT resulting in the detection of ossification centers in the SIJ in individuals aged >15 years. In children and adolescents, CT evaluation was performed in one study with the purpose of evaluating developmental features. A literature review resulted in a few studies analyzing the anatomy of the SIJ based on CT in adults two of these focused on prevalence and appearance of anatomical variants. However, due to exposure to ionizing radiation, CT is not commonly used as the diagnostic method for diagnosing SIJ changes, especially not in children and adolescents.įor both adults and children/adolescents, early and correct diagnosis of inflammatory changes in the SIJ is only possible with precise knowledge of the structural anatomy and developmental variation of SIJ. Computed tomography (CT) is superior to MRI for visualizing detailed osseous anatomy in addition to pathological structural lesions and can display chronic osseous changes in sacroiliitis, but not signs of inflammatory activity. Usually both active and chronic MRI findings are required to establish the diagnosis in children and adolescents and distinct knowledge about the complicated anatomy of SIJ is therefore important. One of the explanations for somewhat different sacroiliac joints changes in children/adolescents compared with adults is the persistence of growth related edematous changes and lack of a clear delineation of minor osseous structures by MRI in juvenile patients this is often a big challenge for radiologists. Inflammatory changes in the sacroiliac joints is also frequent in juvenile spondyloarthritis (JSpA) but the classification or diagnostic criteria used in adults seems not to be applicable in juvenile patients. Since 2009 bone marrow edema (BME), highly suggestive of sacroiliitis, has been part of the classifications criteria for adult SpA as defined by Assessment of SpondyloArthritis (ASAS) International Society. In adults the early diagnosis of sacroiliitis is currently based on magnetic resonance imaging (MRI). The sacroiliac joints (SIJ) play an important role in spondyloarthritis as the diagnosis often is confirmed based on sacroiliitis by imaging. Attention to these normal anatomical structures during growth may help to avoid false positive findings by MRI. Normal osseous SIJ structures in children and adolescents vary considerably. The anatomy of the SIJ was retrospectively analyzed in 124 trauma patients aged 9 months – 3 mm occurred in 21 children/adolescents (17%) located to both the iliac and sacral joint facets. ![]() ![]() This study analyzed the normal osseous anatomy of the sacroiliac joints (SIJ) in a juvenile population using computed tomography (CT). Diagnosing sacroiliitis by magnetic resonance imaging (MRI) in children/adolescents can be difficult due to the growth-related changes.
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