Objective

The study aims to investigate the prevalence and neglected rate of sacroiliitis on lumbar spine computed tomography (CT) in patients with low back pain.

Materials and methods

From January 2016 to December 2020, a total of 4827 patients (mean age: 35.4 ± 9.5 years) who underwent lumbar spine CT examinations were included in this retrospective study. The CT degree of sacroiliitis in all study population were retrospectively reviewed by two radiologists. The independent sample t-test was used to compare the continuous values and chi-squared or Fisher’s exact test was used to compare the categorized values.

Results

Sacroiliitis was identified in 514 of 4827 patients (10.6%). Patients with sacroiliitis were significantly younger than those without sacroiliitis (32.1 ± 8.9 vs. 35.8 ± 9.5 years, p < 0.001). Moreover, significantly more patients with sacroiliitis had HLA-B27 (p < 0.001) positivity and inflammatory back pain syndrome (p = 0.003) than those without sacroiliitis. Among the 514 patients, sacroiliitis was recognized on primary reading in 386 patients (75.1%) but was neglected in the remaining 128 patients (24.9%). Of the 386 patients, 371 patients were followed up, and finally, 295 patients of them (79.5%) were diagnosed with axSpA.

Conclusion

Radiologists should pay careful and more attention to sacroiliac joint on lumbar spine CT for early diagnosis of sacroiliitis in young patients with low back pain, which could result in early diagnosis and treatment of axSpA.

中文翻译：

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腰痛患者腰椎CT骶髂关节炎患病率及被忽视率

客观的

该研究旨在调查腰痛患者腰椎计算机断层扫描（CT）中骶髂关节炎的患病率和被忽视率。

材料和方法

本回顾性研究共纳入 2016 年 1 月至 2020 年 12 月接受腰椎 CT 检查的 4827 例患者（平均年龄：35.4±9.5 岁）。两位放射科医师回顾性审查了所有研究人群中骶髂关节炎的 CT 程度。独立样本t检验用于比较连续值，卡方或 Fisher 精确检验用于比较分类值。

结果

4827 名患者中有 514 名 (10.6%) 被确诊为骶髂关节炎。骶髂关节炎患者明显比没有骶髂关节炎的患者年轻（32.1 ± 8.9 对 35.8 ± 9.5 岁，p  < 0.001）。此外，与没有骶髂关节炎的患者相比，有明显更多的骶髂关节炎患者具有 HLA-B27 ( p  < 0.001) 阳性和炎症性背痛综合征 ( p  = 0.003)。在 514 名患者中，有 386 名患者 (75.1%) 在初次阅读时识别出骶髂关节炎，但在其余 128 名患者 (24.9%) 中被忽视。386例患者中，371例获得随访，最终确诊axSpA的有295例（79.5%）。

结论

放射科医师在腰椎CT上应注意骶髂关节，对年轻腰痛患者的骶髂关节炎进行早期诊断，从而实现axSpA的早诊早治。