Sacroiliitis – early diagnosis is key

Gleb Slobodin,1,2 Haya Hussein,1 Itzhak Rosner,1,2 Iris Eshed3,4 1Rheumatology Unit, Bnai Zion Medical Center, Haifa, Israel; 2Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel; 3Department of Diagnostic Imaging, Sheba Medical Center, Tel Aviv, Israel; 4Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Abstract: Sacroiliitis, inflammation of the sacroiliac joint (SIJ), may be associated with many rheumatic and nonrheumatic disorders. The diagnosis of sacroiliitis may be difficult in many patients, and awareness of its typical manifestations along with recognition of its diverse presentations and cognizance of the limitations of today’s imaging modalities are critical to good clinical practice. This review presents the didactic approach to the early diagnosis of sacroiliitis in patients with suspected axial spondyloarthritis and other nosologic entities, discussing also differential interpretation of information acquired from patients’ histories, physical examination, and imaging. Keywords: sacroiliitis, axial spondyloarthritis, diagnosis, imaging, Sacroiliac joint, differential diagnosi