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MRI of the sacrum and ilium. MRI of the sacroiliac joints in St. Petersburg, which shows how much MRI of the sacroiliac joints and hip joints costs

Magnetic resonance imaging of the sacral iliac joints suitable for identifying early stages Ankylosing spondylitis and rheumatoid polyarthritis. This method does not use diagnostics x-ray radiation, therefore absolutely safe for the patient.

When is it appointed?

The doctor prescribes diagnostics for the following indications:

  • suspicion of the development of ankylosing spondylitis and its particular manifestation - sacroiliitis
  • genetic predisposition to ankylosing spondylitis (its diagnosis in parents or relatives) or isolation of the HLA-B27 gene in the patient
  • a diagnosis of “osteochondrosis”, in which the pain does not go away for a long time and is not relieved by anti-inflammatory drugs, cervical and lumbar lumbago
  • inflammatory diseases of the joints of the lower extremities (especially the ankle)
  • chronic back pain leading to decreased performance and difficulty moving
  • decreased flexibility and mobility of the spine
  • injuries to the lower back and pelvic bones

An examination may also be prescribed to see the dynamics of an already diagnosed ankylosing spondylitis or other rheumatoid arthritis.

What does an MRI of the sacroiliac joints show?

  • foci of inflammation in spinal cord, spinal discs and joints
  • widening of the joint space
  • formation of bone spurs
  • foci of calcium deposition in the articular-ligamentous apparatus
  • joint injuries
  • tumor processes

MRI with contrast

In some cases, the most detailed visualization of the problem area is necessary to make a diagnosis. Then the patient is asked to use a gadolinium-containing contrast agent. This procedure allows better visualization of small inflammatory foci in the spine and joints. The contrast agent is administered intravenously, and after the procedure it is eliminated from the body naturally within several hours.

IN in rare cases Allergic reactions may occur, so this study is carried out only with the direction of the attending physician or radiologist.

MRI with contrast increases the cost and duration of the procedure by 1.5 - 2 times; without the introduction of contrast it lasts from 15 to 20 minutes.

Standard restrictions are pregnancy, the presence of metal grafts in the body and other factors. You can find out more about them on the website in the section General contraindications for MRI.

In addition to magnetic resonance imaging at Ramsey Diagnostics centers, patients are given the opportunity to undergo CT/MSCT of the lumbosacral spine.

Advantages over CT

MRI allows you to diagnose pathological changes in the joints and spinal cord at the earliest stages of the disease, when the patient does not feel any unpleasant symptoms. Computed tomography allows you to identify obvious degenerative changes bone and joint tissue, when treatment becomes practically ineffective. We should not forget that the majority of patients are men reproductive age And x-ray irradiation SIJ area is extremely undesirable for their offspring.

Thanks to modern diagnostic methods it is possible to see the structure, appearance and the location of a wide variety of tissues and organs. The sacroiliac joints are located in hard to reach place and they are not easy to palpate. Modern diagnostic equipment comes to the rescue to assess their condition. MRI of the sacroiliac joints has no equal in terms of information content and safety.

MRI can easily detect pathologies of the sacroiliac joints

In this article you will learn:

What is the essence of the study

Pathological processes in the sacrum area occur very rarely, and therefore targeted scanning is done infrequently. Magnetic resonance imaging has been categorized as the safest and most informative method. Similar procedure helps to identify various pathologies in this part of the body even before the first symptoms appear. This is very important, because the patient’s chance of starting treatment on time increases many times over, thereby avoiding unpleasant complications.

The procedure is carried out without x-rays and is therefore considered safe. An MRI of the sacroiliac joints shows a clear and detailed image of the problem part of the body. The information obtained allows us to examine the pathology from all angles.

The duration of MRI of this area is about 40 minutes. Take finished result possible in an hour.

In what cases is it performed?

MRI sacral region prescribed when the information obtained through other diagnostic measures is not enough to make a correct diagnosis.

MRI of the sacral region is performed for injuries

Such a study is prescribed:

  • if the patient injures this area;
  • in case of development of tissue pathologies;
  • if during movement atypical sounds are heard in the sacral area;
  • with sudden onset of lameness;
  • in case of swelling, redness or heat in the sacral area;
  • if tension occurs in this part of the body during sudden movement;
  • if the patient complains of a feeling of discomfort or pain in the lower back, not only during movement, but also in a calm state;
  • if the flexibility of the spine has decreased and movements have become more constrained;
  • in case of cramps in the calf muscles.

Such an examination is prescribed if the doctor suspects oncological diseases or changes in blood vessels in the study area.

MRI diagnostics is also indicated for seizures

What preparation is required

Special for tomography preliminary preparation not needed. No restrictions on food, medications or physical activity. If you plan to introduce contrast agent, then care must be taken in advance to ensure that the patient’s stomach is empty. Before performing a tomography you should:

  • get rid of watches and jewelry;
  • clothing should be loose and not contain metal parts or inserts;
  • take everything out of your pockets;
  • take off hearing aid, any types of dentures, even dental ones;
  • have the results of your previous examination with you.

To feel more comfortable, it is recommended to wear earplugs or special headphones before the examination.

Important! Throughout the entire procedure, it is important for the patient to lie absolutely still, remain completely calm until the end and follow all the doctor’s recommendations.

How does the procedure work?

Shortly before the MRI procedure, the patient must prepare documents, in particular: a medical record with detailed description diseases, information about other studies, a certificate about which drugs you may be allergic to.

Before the test you should not smoke or drink

You can consume any food before the examination, but alcohol and tobacco products It is recommended to temporarily stop.

Carrying out a diagnostic scan includes certain steps:

  1. The doctor assesses the patient’s condition and examines the available documentation. He also advises the patient regarding the specifics of the procedure.
  2. The subject is placed on the table and, in order to ensure his immobility, his arms and legs are secured with special belts.
  3. To protect the patient's hearing aid from the loud sounds produced by the tomograph, special headphones are placed on his ears.
  4. If necessary, contrast is administered intravenously. In this case, you may feel a slight cold, which quickly passes.
  5. The table with the patient is completely immersed in the camera of the device.
  6. Next, the scanning itself begins, which can take from 30 minutes to 2 hours.
  7. Upon completion of the examination, the table is pulled out and the patient stands up.

During an MRI, a person lies down while the machine takes pictures.

Important! The patient does not experience any pain or discomfort during the examination.

What are the features of MRI with contrast?

Sometimes an MRI of the sacroiliac joints requires the use of a contrast agent that is injected into a vein. Contrast is needed to identify vascular or tumor pathologies.

The role of contrast is safe drugs, which are based on gadolinium. Development risk allergic reaction minimum.

It is possible to obtain a clearer and more informative picture of the images due to the uniform distribution of the contrast agent throughout the vessels of the whole body. The contrast agent is removed independently, naturally, through certain time after the procedure.

What is MRI with contrast? You can learn about this from this video:

What changes are visible on MRI

MRI examination of the sacroiliac zone makes it possible to determine the condition of the soft tissues, as well as whether there are pathologies, in particular:

  • whether ankylosing spondylitis develops (when the spinal column becomes like a bamboo stick);
  • whether there is inflammation in the spinal cord or vertebrae;
  • are there any neoplasms;
  • the nature of spinal injuries, if any;
  • development of arthrosis or arthritis.

Diagnosis pathological processes in the spine on early stages makes it possible not to delay treatment and prevent further development diseases. In many cases, thanks to such timely diagnosis, the chances of avoiding disability are high.

Upon completion of the MRI procedure, the results obtained are deciphered by a specialist who writes an appropriate conclusion. Based on these data, the doctor prescribes the necessary therapy.

An experienced doctor should study the images and make a diagnosis.

Is MRI dangerous for the body?

Magnetic resonance imaging is an absolutely safe examination. Scanning is carried out using powerful magnetic field. The radio pulse influences the protons of hydrogen atoms that make up the human body. Software transfers the received information to the doctor’s computer monitor.

Important! MRI is completely harmless for humans, but only if there are no contraindications.

What are the contraindications for the procedure?

The magnetic field is completely harmless to humans. But it is important to remember that it affects metals that have the ability to be magnetized. Therefore, MRI is strictly prohibited for patients with metal implants in the body (meaning pacemakers, endoprostheses, etc.).

Important! If the implants are made of titanium or its alloys, then MRI can be done.

Besides, diagnostic procedure contraindicated in the following cases:

  • pregnant women (especially in the first trimester);
  • when breastfeeding;

People with renal failure MRI is not recommended

  • suffering from renal or liver failure;
  • if you are allergic to compounds containing gadolinium;
  • diagnosed with epilepsy or seizure disorder.

Also, MRI is contraindicated for people with claustrophobia.

Magnetic resonance imaging of the sacroiliac region is an important and necessary examination. Thanks to high-quality three-dimensional images, it is possible to accurately make the correct diagnosis and prescribe competent therapy.

Pain in the lower back indicates possible problems with the joints of the sacrum and pelvis, which requires a thorough examination. (MRI) of the sacroiliac joints is the most effective and accurate diagnostic method. With its help, you can not only identify various pathologies in the early stages, but also to evaluate the effectiveness of the treatment.

These joints are a paired joint of the pelvic girdle (available on both sides), represented by the sacrum and ilium.

The first is part of the pelvis, connecting with the ischium and pubic bones, they form a single base.

The sacrum consists of five fused vertebrae of the lower part spinal column. It is located between the two iliac planes and has a small auricular surface, exactly the same as on the ilium. The articulation of these two ear-shaped surfaces is called the sacroiliac. This is a low-moving joint, the inner part of which is covered with cartilage tissue.

It is considered a very important component of the body, as it performs the following functions:

  • allows the body to bend in different directions;
  • fixes the body position in a sitting position;
  • absorbs movements when walking and playing sports;
  • plays a role in the articulation of the bones of the lower spine.

That is why any disturbances in the functioning of the sacroiliac joint can lead to serious consequences, up to and including disability.

When diagnosis is required - alarming symptoms

Depending on the patient’s complaints, or if any pathology is suspected, the doctor gives a referral for a tomography.

MRI diagnostics of the sacroiliac joint is required in the following cases:

  • if pain occurs in the back area, in its lower part;
  • there is inflammation in soft tissues, in contact with the sacroiliac joints;
  • there is a crunch or other uncharacteristic sounds in the sacrum;
  • lameness occurs periodically;
  • swelling at the joints;
  • bothered by attacks of heat in the sacral area;
  • if family members have ankylosing spondylitis, which is inherited;
  • availability various kinds spinal abnormalities;
  • there are chronic;
  • if there is mechanical injuries this area;
  • for periodic inflammations;
  • to analyze the dynamics of the development of such pathologies as ankylosing spondylitis and rheumatoid arthritis, as well as to evaluate the effectiveness of their treatment.

How does the procedure work?

In order to perform an MRI procedure of the sacroiliac joint, a small special training. First of all, you need to prepare a number of documents, which are provided to the specialist in advance. These include medical card With detailed description medical history, data from other examinations and a certificate indicating the drugs to which you have an allergic reaction.

There is no need to give up food and drink, but it is better to avoid alcohol and cigarettes for a while. No motor restrictions are required.

MRI scanning is carried out in several stages:

  1. The doctor assesses the patient’s condition and reviews the documents provided. Explains in detail how tomography is performed and what is required of the patient.
  2. Then the patient removes all metal-containing objects and lies down on the tomograph table. Since it is necessary to maintain a motionless position during the procedure, the arms and legs are secured with belts.
  3. The person being examined is either put on headphones or given earplugs to protect the hearing aid from the loud noise produced by the tomograph.
  4. If contrast is needed for diagnosis, it is administered intravenously. There may be a slight chill that goes away after a couple of minutes.
  5. The table moves in such a way that the area of ​​the body being examined is completely immersed in the device.
  6. The scanning process takes place, lasting from thirty minutes to an hour. None pain and there should be no discomfort during the entire procedure. Feeling light heat in the body is considered normal.
  7. The table slides out and the procedure is considered complete.

The patient can receive images within an hour after diagnosis, which is another advantage of tomographic examination.

About contraindications

Magnetic resonance imaging involves the effect of a powerful magnetic field on the body. Despite the safety of the procedure, it is not suitable for everyone. to carry out this type of diagnosis are:

  • pregnancy, especially the first trimester during the formation of the main significant structures of the fetus. In extreme cases, they try to carry out tomography closer to the third trimester, when the risk of harming the child is significantly reduced;
  • lactation, while feeding the baby breast milk It is not necessary to carry out diagnostics with contrast. The injected substance enters the child’s body through the mother and can provoke an allergic reaction;
  • metal objects in the body that cannot be eliminated. These include braces, plates, implants, dentures, etc. The exception is titanium elements. Since it is an inert metal, a magnet has no effect on it. However, it is still necessary to inform the specialist about the presence of titanium inserts, since it may be necessary to change the device settings;
  • if the patient is in very serious condition;
  • fear of closed spaces, occurrence panic attacks. Acceptance needed sedatives. IN as a last resort when claustrophobia is serious, you cannot do without light anesthesia while you are in the tomography machine;
  • renal or liver failure;
  • high sensitivity of the body to foreign substances, in in this case to contrast;
  • if your body has an electronic pacemaker, hearing aid, insulin pump or neurostimulator. A magnetic field can disable these mechanisms;
  • when body weight exceeds 120 kilograms, diagnostics will not be possible, since the capabilities of the device are limited by this figure.

Decoding the results - what pathologies can be identified

The results of MRI studies of the sacroiliac joint are transmitted to the attending physician. It analyzes the images and identifies deviations in them. Thus, using scanning, the following pathologies can be identified:

  • violation of the integrity, anomalies and other damage to the joints;
  • what stage of development is osteochondrosis at;
  • protrusion of intervertebral discs;
  • places of soft tissue injury;
  • osteochondrosis;
  • deposition of excessive amounts of calcium salts in blood vessels
  • the presence of neoplasms of various types, most often detected intervertebral hernia and cysts;
  • pinched nerves of the spinal cord;
  • where the inflammation is located, and the presence of fluid around the lesions and its quantity is also detected.
  • arthritis of different types
  • Bekhterev's disease, characterized by ossification of the vertebrae and muscles;
  • places where cartilage is damaged
  • insufficient blood circulation in the joint area;

To assess the condition of blood vessels and circulatory system, as well as to determine the nature and parameters of neoplasms, it is necessary contrast enhancement. For this purpose, drugs based on gadolinium are used.

After decryption of images it is usually not necessary additional research, since the scan is often sufficient to make an accurate diagnosis. Based on the results obtained, the doctor decides on further treatment or referral of the patient to another specialist.

Conclusion

MRI of the sacroiliac joint allows you to identify pathology in the early stages and stop the process, preventing the disease from progressing. Timely diagnosis allows you to avoid not only unpleasant consequences, but also wheelchair. Therefore, if you have certain symptoms, you should undergo a tomographic examination as soon as possible.

The sacroiliac joints do not have increased mobility. The joints provide a fixing function, create strength for the “structure” of the sacrum and iliac bones. Damage to the area leads to pain syndrome, limited mobility of the hip joints. The most frequent illnesses– rheumatoid polyarthritis, sacroiliitis, ankylosing spondylitis. Early detection changes in the iliosacral region using radiography, magnetic resonance and computed tomography prevents irreversible consequences with proper treatment.

The latest types of MRI of joints are able to verify formations larger than one millimeter in diameter.

What is magnetic resonance imaging

The harmlessness of the MRI method for human health is due to the use of a magnetic field that promotes the resonance of hydrogen atoms. Magnetization causes radio frequency distortion by tissues containing water. Signal registration, subsequent processing by a software application, provides a graphic image.

The magnetic resonance phenomenon is used in medicine for diagnostic purposes. The operating modes of the tomograph show tissues of different densities - connective, fat, muscle.

When explaining what MRI is, it is necessary to note different design features installations on the weight limits of the table, tunnel design. The open type of devices is rarely used for diagnosing the sacroiliac joints due to low resolution. The equipment is used for tomography of patients with fear of closed spaces.

Tomography qualitatively shows the sacral joints when scanning with closed tomographs. Products have powerful magnet(1.5-3 Tesla), allowing to verify lesions with a diameter of over 0.3 mm.

MRI is an expensive diagnostic method. Well visualizes soft tissue structures - ligaments, muscles, cartilage. Sacral joints are clearly visible on tomograms, which makes it possible to verify inflammatory, oncological, and degenerative-dystrophic processes.

The price of extremity scans varies. High cost MRI of the legs is explained by the difficulties of examining the knee.

What are sacroiliac joints

Located on both sides of the sacrum. They have limited mobility. They consist of developed cartilaginous structures and a strong capsular membrane. The anatomical design firmly fixes the formation to the pelvis and spinal column.

MRI of the sacroiliac region - what it shows

Inflammatory changes in the iliosacral joints are specific. Because of the abundance cartilage tissue there is a danger of bacterial infection, reactive arthritis. Bilateral or unilateral sacroiliitis accompanies several types inflammatory processes:

  1. Reactive arthritis;
  2. Spondyloarthritis;
  3. Ankylosing spondylitis.

The consequence of the condition is sacroiliac joint syndrome, which causes pain in the hip joint, thigh, and leg. Symptoms due to infringement nerve fibers, emerging from the spinal column, spreading to lower limbs. Compression is not necessarily achieved by an inflammatory process. Increased tone piriformis, iliopsoas, abductors and piriformis muscles promotes pinching of nerve fibers spreading to the legs.

Ankylosing spondylitis on MRI of the sacrum

The initial stage of ankylosing spondylitis (ankylosing spondylitis) is determined by MRI of the sacroiliac joints by identifying narrowing of the joint space, subchondral osteosclerosis of surfaces, and accumulation of inflammatory fluid. The inflammatory process is proliferative in nature with bone growths and deposition of calcium salts along the spinal ligaments. Syndesmophytes and enthesophytes are clearly visible on radiographs in the form of a “bamboo stick” symptom. The changes are characteristic of stage 3 of the disease.

What changes does MRI detect in ankylosing spondylitis:

  • Destruction of the femoral head;
  • Sclerotic changes in bones;
  • Formation of erosions;
  • Inflammation of the joint capsule (capsilit);
  • Infiltration of ligaments (synovitis).

The late stage of ankylosing spondylitis is accompanied by a narrowing of the iliosacral joint gap. An MRI is not necessary. Signs of stage 4 sacroiliitis will be shown by pelvic x-ray.

An MRI scan in a patient with an early stage of ankylosing spondylitis allows us to identify concomitant pathologies:

  1. Tarzit;
  2. Fusion of the frontal articulation;
  3. Inflammatory processes large joints(hip, knee).

Magnetic resonance imaging of inflammation of the sacral areas

Sacroiliitis is classified into primary and secondary. The first form is caused by changes in the connection of the sacrum and ilium. Accompanies injury infectious processes, tumors.

Secondary sacroiliitis occurs against the background of other diseases - systemic changes connective tissue(scleroderma, lupus erythematosus, seronegative spondyloarthropathies). Magnetic resonance imaging can reveal early signs pathologies - subchondral osteosclerosis, erosion, loss of bone density.

An MRI of the knee for arthrosis is performed simultaneously with an examination of the iliac joints to exclude ankylosing spondylitis (ankylosing spondylitis).

How to do an MRI of the iliosacral joints in stir mode

Over the past ten years, approaches to sacroiliitis have changed significantly. Complex pathological changes, arising from psoriatic and a number of other arthritis, experts have combined the term “spondyloarthritis”. The classification summarizes the complex of pathologies with damage to the spinal column and sacroiliac joints. The identification of “pre-radiological arthritis” allows the use of MRI of joints for early verification of diseases.

According to international classification all changes in the sacroileal areas are divided into 2 categories - structural and inflammatory. The first manifestations are irreversible. Timely detection of inflammation helps prevent the development of the disease.

Inflammatory signs of sacroiliitis on MRI:

  • Capsulitis;
  • Enthesitis;
  • Synovitis.

Structural manifestations:

  • Fatty infiltration;
  • Erosion;
  • Osteosclerotic changes.

Modern MRI of the joints of the pelvis and sacrum with the presence of stil mode helps to detect the described morphological manifestations. A scanning feature is the use of an echo gradient with signal suppression of adipose tissue.

Comprehensive MRI diagnostics of the sacral joints involves the use of MR modes with T1-weighted imaging. The dark signal is formed from inflammatory hyperintense areas. Creates a similar picture intervertebral disc, liquor

Differential diagnosis is helped by MRI with contrast for the sacroiliac joints. Gadolinium changes the signal intensity in the inflammatory segment.

Sacral tumors on MRI

Sacral neoplasms are diagnosed late due to the presence of large free space inside. More than two years pass from the appearance of the tumor to the pinching of the nerves.

What formations does MRI of the pelvic joints show:

  1. Perineural cysts;
  2. Myelomeningocellus;
  3. Abscesses;
  4. Arteriovenous malformations;
  5. Vascular aneurysms.

Clinical symptoms arise gradually as the tumor grows and nerves are pinched.

Principles of decoding magnetic resonance imaging

Tomograms are interpreted in St. Petersburg qualified specialists. Depending on how busy the doctor is, the description will be completed in at least 30 minutes. Private clinics in St. Petersburg offer the service of sending tomograms by email.

The initial changes in the sacroilial joints are shown by a high-power tomograph. When choosing diagnostic center Please note that the device has a stil mode, which allows you to verify inflammatory processes.

The sacroiliac joint is the connection between the iliac bones and the sacrum. The formation is located in the lower back, slightly below the waist. MRI of the sacroiliac joints is a safe and most informative technique for studying them. Using visual data, it is much easier for a doctor to determine the presence of a disease and outline a plan for future treatment.

MRI machine PHILIPS INTERA 1.5T


The PHILIPS INTERA 1.5 T MRI machine is designed with increased patient comfort and increased bandwidth systems. This is achieved thanks to a wide tunnel, which virtually eliminates the risk of claustrophobia and provides excellent access to the patient due to the minimum length of the straight tunnel section compared to other similar systems and a wide bell.

What does an MRI of the sacroiliac joints show?

The ability to detect pathology in the early stages is one of the main advantages of MRI. Even small formations will not escape the eye of the technology, which significantly affects the effectiveness of treatment. In the case of MRI of the sacroiliac joints, the price varies in different areas and depends on many factors. The procedure shows:

  • the presence or absence of damaged cartilage tissue at the joint;
  • accumulation of fluid in inappropriate places;
  • areas of excessive calcium deposition;
  • joint gap width;
  • various bone pathologies and growths.

Magnetic resonance scanning is widely used in developed countries. Most diagnoses are based on it. This applies to even the most complex diseases and disorders.

Indications for MRI of the sacroiliac joints

  • Development of inflammatory processes. This group includes tuberculosis, ankylosing spondylitis, arthritis, sacroiliitis, and Reiter's disease.
  • Injuries suffered. MRI of the sacroiliac joints is prescribed if sudden pain occurs after injury. The cause may be a difficult birth, a pelvic fracture in the past, increased load on the spine, sharp bend, etc.
  • Osteoarthritis. Either a developed disease or suspicion.
  • Genetic abnormalities. It might be different lengths legs, asymmetrical pelvic design, etc.

Contraindications to MRI of the sacroiliac joints

  • use of pacemakers and other implants;
  • pregnancy or breastfeeding;
  • vessel clips;
  • metal elements (plates, screws, bolts, various types of fasteners);
  • any other valves, pumps, nerve stimulators containing metal.

Preparation for MRI of the sacroiliac joints

No special preparatory measures are required for MRI of the sacroiliac spine. Rather, you must be prepared psychologically. Sign up for the procedure at convenient time, do not be nervous, follow all the specialist’s instructions. Then the scanning results will be of high quality.