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Objective: Magnetic resonance imaging (MRI) can reliably detect inflammation and structural changes in sacroiliac joints (SIJs) in patients with lower back pain (LBP). However, patients with LBP are usually referred for MRI of the lower back (e.g. lumbar spine LS), and imaging of the SIJs is rarely requested for these patients. The aim of this work is to use radial MRI as an additional screening technique for SIJ pathology presenting in lumbar spine patients with chronic LBP. Materials and methods: One hundred one (54 males/47 females) patients complaining primarily of LBP were screened using a 1.5-T MRI system. MRI scanning was performed using sagittal and axial T2-weighted sequences for the LS (12 min) and the radial T2-weighted-fat saturated sequence for the SIJs (1.20 min). Two radiologists specializing in musculoskeletal MRI individually evaluated the SIJ images for anatomical accuracy and pathology. Results: Almost all radial SIJ images (95%) were diagnostically acceptable for reporting; 73.3% showed LS pathology only, whereas 26.7% displayed a combination of LS and SIJ pathology. Secondary findings indicate a significant correlation with gender (p = 0.014), namely, females were more prone to SIJ disease than males. Conclusion: Radial images were used to detect the presence and size of the anatomical deformity in LBP patients. Patients with detected pathology were then recommended for further follow-up and full diagnostic examination. discs), SIJs are frequently not considered in the clinical diagnosis [1]. In addition, early sacroiliitis is often not visible on conventional radiographs (X-ray) or is difficult to interpret, which may lead to a long delay in establishing a diagnosis (more than eight years between the initial presentation and diagnosis) [2,3]. For most patients, back pain symptoms are nonspecific. Anatomically, the spine is the leading source (82%) of LBP; however, clinicians need to be aware of the possibility of non-spinal pain generators, such as the hips and SIJs, as they are significant sources in 25% of LBP cases [4,5]. Among the available imaging techniques, magnetic resonance imaging (MRI) plays an important role in the diagnosis of sacroiliac disorders [1]. MRI is an examination that decreases the delay between the initial presentation of symptoms and diagnosis because it can detect inflammation at early stages [6,7]. The development of MRI technology has undoubtedly exceeded expectations in the last decade and has been boosted by advances in high-field magnet and computer technology [8]. However, MRI can take a long time when multiple body regions are scanned; on average, imaging of the lumbar spine (LS) requires 20 to 45 min, depending on the region being scanned [9]. Routine sequences for SIJs will increase the scanning time by a factor of two, depending on the imaging planes and the region scanned. Orthogonal and oblique planes are the most commonly used conventional anatomical planes, and a full scan of two or three of these planes can take from 15 to 35 min [9,10]. *Corresponding author: Dr. Muna Al-Mulla, Ph.D., MR Specialist, Medical Imaging Department, Al Sabah Hospital, Kuwait University, Kuwait, E-mail: muna@HSC.EDU.KW OriginAl Article

Radial MR Screen of the Sacroiliac Joints in the Lumbar Spine of Patients with Chronic Lower Back Pain