除了一些病例报告,尚未研究骨软骨瘤病的骶髂关节(SIJ)受累。我们旨在使用横断面成像来确定这种参与的患病率和特征。
在这项回顾性研究中,3名观察员(1名初级放射科医师和2名肌肉骨骼放射科医师)独立回顾了我们数据库中患有骨软骨瘤(≥2例跨骨骼骨软骨瘤)的患者的计算机断层扫描(CT)或磁共振成像(MRI)的SIJ受累.最终决定是由两位肌肉骨骼放射科医生在后来的联席会议上达成的共识。
在我们数据库中的36例骨软骨瘤病患者中,22例(61%)有覆盖SIJ的横断面成像(14例女性,男性8例;年龄范围7-66岁;平均年龄23岁;MRI13例,9CT)。其中,16例(73%)患有关节内骨软骨瘤。为了在横断面成像中识别SIJ骨软骨瘤,肌肉骨骼放射科医师和初级放射科医师与两位肌肉骨骼放射科医师的最终共识决定之间的观察者间达成了实质性共识[κ=0.67;95%置信区间(CI):0.34,1.00]。在横断面成像的队列中,在6例有(n=2)和无(n=4)骶髂骨软骨瘤的不同患者中发现了附件SIJ(n=6,27%)和髂骶复合体(n=2,9%)的解剖变异.
横断面影像显示SIJ频繁(73%)受累于骨软骨瘤病,which,虽然是一种罕见的疾病,然而,在鉴别诊断此类SIJ解剖变异体如副SIJ和髂骶骨复合体时,需要加以考虑.在骨软骨瘤病患者中,将这些变体与骨软骨瘤区分开具有挑战性。
Apart from a few case reports, sacroiliac joint (SIJ) involvement in
osteochondromatosis has not been studied. We aimed to determine the prevalence and characteristics of such involvement using cross-sectional imaging.
In this retrospective study, three observers (one junior radiologist and two musculoskeletal radiologists) independently reviewed computed tomography (CT) or magnetic resonance imaging (MRI) of patients in our database who had
osteochondromatosis (≥2 osteochondromas across the skeleton) for SIJ involvement. The final decision was reached by the consensus of the two musculoskeletal radiologists in a later joint session.
Of the 36 patients with
osteochondromatosis in our database, 22 (61%) had cross-sectional imaging covering SIJs (14 females, 8 males; age range 7-66 years; mean age 23 years; 13 MRI, 9 CT). Of these, 16 (73%) had intra-articular osteochondromas. For identifying SIJ osteochondromas on cross-sectional imaging, interobserver agreement was substantial [κ = 0.67; 95% confidence interval (CI): 0.34, 1.00] between the musculoskeletal radiologists and moderate (κ = 0.59; 95% CI: 0.23, 0.94) between the junior radiologist and the final consensus decision of the two musculoskeletal radiologists. In the cohort with cross-sectional imaging, the anatomical variations of the accessory SIJ (n = 6, 27%) and iliosacral complex (n = 2, 9%) were identified in six different patients with (n = 2) and without (n = 4) sacroiliac osteochondromas.
Cross-sectional imaging shows frequent (73%) SIJ involvement in
osteochondromatosis, which, although a rare disorder, nevertheless needs to be considered in the differential diagnosis of such SIJ anatomical variants as the accessory SIJ and iliosacral complex. Differentiating these variants from osteochondromas is challenging in patients with
osteochondromatosis.