Magnetic resonance imaging guided corticosteroid injection of the sacroiliac joints in patients with therapy resistant spondyloarthropathy: A pilot study

Objective. To evaluate magnetic resonance imaging (MRI) guided corticostero id injections of inflamed sacroiliac (SI) joints in patients with spondyloa rthropathy with therapy resistant sacroiliitis. Methods. We performed 16 injections in 9 patients on an outpatient basis (6 men, 3 women, mean age at onset 24.7 +/- 7.5 yrs). All patients had MRI gu ided injection of 40 mg triamcinolone acetonide into SI joints using an ope n 0.2 Tesla unit. Before and 3 months after corticosteroid injection they u nderwent an MRI examination with a closed 1.5 Tesla unit. Results. Seven of 9 patients reported subjective improvement that lasted at least a mean of 10.8 +/- 5.6 months. Subchondral bone marrow edema on fat suppressed images resolved in 8 patients after corticosteroid injection. Conclusion. MRI guided corticosteroid injection of SI joints appears to be an effective and safe procedure without exposure to radiation. It is a usef ul therapeutic modality, especially in young patients with severe isolated sacroiliitis.