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. 2019 May 23;103(1):36.
doi: 10.5334/jbsr.1648.

Degeneration of the Sacroiliac Joint in Hip Osteoarthritis Patients: A Three-Dimensional Image Analysis

Maki Asada  1 , Daisaku Tokunaga  2 , Yuji Arai  1 , Ryo Oda  1 , Hiroyoshi Fujiwara  1 , Kei Yamada  3 , Toshikazu Kubo  1
Affiliations

Degeneration of the Sacroiliac Joint in Hip Osteoarthritis Patients: A Three-Dimensional Image Analysis

Maki Asada et al. J Belg Soc Radiol. .

Abstract

Objective: The sacroiliac joint is an important source of low back pain and may be influenced by pathologies in adjoining structures such as the hip or the spine. This study aimed to investigate the influence of hip osteoarthritis on sacroiliac joint degeneration by examining the sacroiliac joints of hip osteoarthritis patients, focusing on the localization and quantity of vacuum phenomena.

Materials and methods: The preoperative computed tomography (CT) of 31 female hip replacement candidates (mean age 69.1) and pelvic CT of 34 age-matched controls (mean age 67.9) were used to reconstruct the sacroiliac joints three-dimensionally. The degeneration score of the sacroiliac joints on axial view, as well as the location and volume of vacuum phenomena in the three-dimensionally reconstructed sacroiliac joints, were analyzed.

Results: The total sacroiliac joint degeneration scores were similar in hip osteoarthritis patients and controls but the breakdown of the score revealed that joint space narrowing and vacuum phenomena in the sacroiliac joint increase in hip osteoarthritis, while osteophytes decrease. Three-dimensional reconstruction revealed that the volume of vacuum phenomena in the sacroiliac joint was significantly larger in the hip osteoarthritis group and the vacuum areas were localized in the antero-superior region of the sacroiliac joint.

Conclusion: Our results suggest that hip osteoarthritis and sacroiliac joint degeneration are related, and that with further investigation, the sacroiliac joint may become a new treatment target in hip osteoarthritis.

Keywords: computed tomography; degeneration; hip osteoarthritis; sacroiliac joint; vacuum phenomenon.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
(a) Three-dimensional reconstruction and (b) separation of the sacrum, (c) view of left SI joint surface (area surrounded by yellow bullets), and (d) vacuum phenomenon (red) overlaid on the joint surface.
Figure 2
Figure 2
Representative axial views of SI joints exhibiting degenerative changes. (a) Vacuum phenomena and joint space narrowing were more distinguishable in hip OA (case no. 23 of Figure 5), while (b) the control displayed more pronounced osteophytes.
Figure 3
Figure 3
Volume of vacuum phenomena in SI joints of hip OA patients and controls. (p < 0.001, Mann-Whitney U test).
Figure 4
Figure 4
Relationship between degeneration score and vacuum volume of SI joints in (a) hip OA group and (b) control group.
Figure 5
Figure 5
List of the 31 patients with hip OA; many SI joints show significant area of vacuum phenomena (shown in red). Note that the vacuum tends to be in the anteriosuperior (synovial) part rather than the posterior, ligamentous part of the joints. Patient #31’s enlarged view of bilateral 3-D reconstructed SI joint with overlaid vacuum phenomenon.
See this image and copyright information in PMC

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