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Clin Radiol. 2013 Aug;68(8):785-91. doi: 10.1016/j.crad.2013.02.007. Epub 2013 Apr 3.

Pitfalls in MR morphology of the sterno-costo-clavicular region using whole-body MRI.

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1
Department of Radiology, Aarhus University Hospital, NBG, Aarhus, Denmark. annejuri@rm.dk

Abstract

AIM:

To analyse the imaging findings at the sterno-costo-clavicular (SCC) joint region using whole-body (WB) magnetic resonance imaging (MRI) in healthy individuals to minimize misinterpretation as changes due to spondyloarthritis (SpA).

MATERIALS AND METHODS:

As part of a cross-sectional study of 122 SpA patients, 75 healthy individuals (42/33 males/females; median age 30.3 years; range 17.7-63.8 years) were scanned using sagittal and coronal WB short tau inversion recovery (STIR) and T1-weighted MRI sequences. The SCC region was analysed independently by seven readers for bone marrow oedema (BMO), erosions, subchondral fat signal intensity (FSI), and joint fluid accumulation.

RESULTS:

SCC changes simulating inflammation were reported by four or more of the seven readers in 15 (20%) healthy individuals (12 male/three female; median age 32.1 years; range 20.2-48 years). Thirteen individuals (17%) had changes at the manubriosternal joint (MSJ); five had BMO, one BMO + erosion, four erosion, two erosion + FSI, and one FSI only. Changes at the sternoclavicular joint occurred in three individuals (4%) encompassing erosion, erosion + FSI + BMO, and joint fluid accumulation, respectively. One patient had both MSJ and sternoclavicular joint changes.

CONCLUSIONS:

Findings mimicking inflammatory changes occurred in healthy individuals, particularly in the MSJ. Awareness of this is important in recognition of SCC inflammation in SpA.

PMID:
23561226
DOI:
10.1016/j.crad.2013.02.007
[Indexed for MEDLINE]
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