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

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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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Acknowledgements

We thank all the patients for their participation and willingness to publish their data.

Author information

Authors and Affiliations

  1. Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 35, Entrance C, location C118/ reference point C109, 8200, Aarhus N, Denmark

    Niels Egund & Anne Grethe Jurik

  2. Department of Pathology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark

    Flemming Brandt Sørensen

  3. Department of Rheumatology, Regional Hospital, Silkeborg, Falkevej 1G, 8600, Silkeborg, Denmark

    René Østgård

  4. Department of Rheumatology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark

    Anne Gitte Loft

  5. Department of Forensic Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus, Denmark

    Lene Warner Thorup Boel

Authors
  1. Niels Egund
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  2. Flemming Brandt Sørensen
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  3. René Østgård
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  4. Anne Gitte Loft
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  5. Lene Warner Thorup Boel
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  6. Anne Grethe Jurik
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Corresponding author

Correspondence to Anne Grethe Jurik.

Ethics declarations

The study was not externally funded and none of the authors has conflicts of interest to disclose. The CT-guided biopsies were performed as part of a method development project intended for clinical and diagnostic purposes, approved by the institution, and permission from the Ethical Committee was waived. Informed consents for the use of clinical, imaging, and pathological data were obtained from all patients.

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Egund, N., Sørensen, F.B., Østgård, R. et al. CT-guided transarticular biopsy of the sacroiliac joint: Technique and histomorphological results. A preliminary study. Skeletal Radiol 49, 453–460 (2020). https://doi.org/10.1007/s00256-019-03305-x

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  • DOI: https://doi.org/10.1007/s00256-019-03305-x

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