Prospective evaluation of sacroiliac scintigraphy in chronic inflammatory back pain

Arthritis Rheum. 1980 Sep;23(9):998-1003. doi: 10.1002/art.1780230906.


To assess the usefulness in screening for sacroiliitis of a wide band profile cut which included the entire sacroiliac (SI) joint, 34 patients with chronic inflammatory back pain (IBP) underwent sacroiliac joint scintigraphy with 99mTc-methylene diphosphonate while receiving no antiinflammatory therapy. The sacroiliac joint to sacrum (SIJ/S) ratios in those with back pain differed significantly from the ratios of an age-matched control group. However, 12 of the 34 patients with inflammatory back pain had normal or equivocal sacroiliac radiographs and 4 of 12 had normal SIJ/S ratios. All 4 were HLA-B27 positive, had diminished lumbar movement, and required antiinflammatory medication; 2 had diminished chest expansion; 1 has developed iritis. We conclude that this technique is not a reliable screening procedure. Therapy with antiinflammatory drugs was associated with a significant decrease in the SIJ/S ratios in 19 of the 34 who were reimaged.

MeSH terms

  • Adolescent
  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Back*
  • Female
  • HLA Antigens
  • Humans
  • Inflammation / diagnostic imaging
  • Male
  • Middle Aged
  • Pain / diagnostic imaging*
  • Prospective Studies
  • Radionuclide Imaging
  • Sacroiliac Joint / diagnostic imaging*
  • Spondylitis, Ankylosing / diagnostic imaging


  • Anti-Inflammatory Agents
  • HLA Antigens