早期骶髂关节炎CT诊断与鉴别诊断

Diagnosis and diiferential diagnosis of early sacroiliitis

目的通过回顾性分析早期骶髂关节炎和结核、创伤性所致骶髂关节改变或容易误诊椎间盘突出所致骶髂部疼痛骶髂关节的CT表现，提高早期骶髂关节炎的CT诊断与鉴别诊断水平。方法本文收集经临床各种检查和追踪确诊的早期骶髂关节炎20例，骶髂关节结核5例，外伤性骶髂关节改变3例，椎间盘突出所致骶髂部疼痛12例，回顾性分析骶髂关节改变的CT特点。结果早期骶髂关节炎的CT典型，可见骶髂关节软骨下线样骨质模糊，伴关节两侧斑点状硬化。有时易与结核、创伤性所致骶髂关节改变混淆。结论CT观察显示骶髂关节骨的病变和软组织改变有明显优势，在早期骶髂关节炎诊断与其他疾病所致骶髂关节改变鉴别中有不可替代的作用。

Objective Sacroiliacpathy caused by early sacroiliitis, tuberculosis and trauma or pain in iliosacral caused by disc herniation were analyzed retrospectively, in order to improve the level of CT diagnosis and differential diagnosis. Methods Twenty cases of early sacroiliitis ,5 cases of tuberculosis of sacroiliac joint and 3 eases of changes of traumatic sacroiliacpathy with various clinical methods and followed - up diagnosis. And we analyzed their CT manifestions of sacroiliacpathy retrospectivly. Results CT findings of typical sacroiliitis was that subebondral liner bone fuzzy, together with bilateral bot sclerosis ,which sometimes easily considered as sacroiliacpathy caused by tuberculosis and trauma. Conclusions CT scan could clearly show the pathologic changes of bone in sacroiliac joint and the soft tissue. And it plays a significant effect on differential diagnosis between early sacroiliitis and sacroiliacpathy caused by other reasons.