In this lecture, Prof. Kay-Geert Hermann provides a comprehensive overview of imaging of the sacroiliac joints (SIJs), emphasizing the strengths and limitations of various modalities, including radiography, CT, MRI, SPECT-CT, and emerging techniques. He explores imaging findings in axial spondyloarthritis, mechanical disorders like osteitis condensans ilii, and the impact of anatomical variants that may mimic pathology. The talk combines practical tips on protocols, lesion recognition, and slice orientation with insights from recent research, offering valuable guidance for both radiologists and rheumatologists involved in diagnosing low back pain and sacroiliac joint diseases.

Learning Objectives

By the end of this lecture, participants will be able to:

• Understand the roles, advantages, and limitations of different imaging modalities for evaluating the sacroiliac joints.
• Recognize key imaging features of sacroiliitis, osteitis condensans ilii, and other sacroiliac joint pathologies.
• Apply optimized MRI protocols and correct slice orientation to reliably assess both inflammatory and mechanical changes.
• Differentiate between true inflammatory findings and anatomical variants or degenerative changes that may mimic sacroiliitis.
• Appreciate emerging imaging techniques such as 3D MRI and susceptibility-weighted imaging in assessing SIJ pathology.