The sacroiliac joint (SIJ) exhibits significant variation in auricular surface morphology. This variation influences the mechanics of the SIJ, a central node for transmitting mechanical energy from upper body to lower limbs and vice versa. The impact of the auricular surface morphology on stress and deformation in the SIJ remains poorly understood to date. Computed tomography scans obtained from 281 individuals were included to extract the geometry of the pelvic ring. Then, the auricular surface area, SIJ cartilage thickness, and total SIJ cartilage volume were identified. Based on these reconstructions, 281 finite element models were created to simulate SIJ mechanical loading. It was found that SIJ cartilage thickness only weakly depended on age or laterality, while being strongly sex sensitive. Auricular surface area and SIJ cartilage volume depended weakly and non-linearly on age, peaking around menopause in females, but without significant laterality effect. Larger SIJs, characterized by greater auricular area and cartilage volume, exhibited reduced stress and deformation under loading. These findings highlight the significant role of SIJ morphology in its biomechanical response, suggesting a potential link between morphological variations and the risk of SIJ dysfunction. Understanding this relationship could improve diagnosis and targeted treatment strategies for SIJ-related conditions.

• Klíčová slova
• finite element simulation, machine learning, sacroiliac joint anatomy,
• MeSH
• analýza metodou konečných prvků MeSH
• biomechanika MeSH
• dospělí MeSH
• kloubní chrupavka * anatomie a histologie   fyziologie   diagnostické zobrazování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• počítačová rentgenová tomografie MeSH
• sakroiliakální kloub * anatomie a histologie   fyziologie   diagnostické zobrazování   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: Radiographic assessment of sacroiliac joints (SIJs) according to the modified New York (mNY) criteria is key in the classification of axial spondyloarthritis but has moderate interreader agreement. We aimed to investigate the improvements of the reliability in scoring SIJ radiographs after applying an online real-time iterative calibration (RETIC) module, in addition to a slideshow and video alone. METHODS: Nineteen readers, randomized to 2 groups (A or B), completed 3 calibration steps: (1) review of manuscripts, (2) review of slideshow and video with group A completing RETIC, and (3) re-review of slideshow and video with group B completing RETIC. The RETIC module gave instant feedback on readers' gradings and continued until predefined reliability ([Formula: see text]) targets for mNY positivity/negativity were met. Each step was followed by scoring different batches of 25 radiographs (exercises I to III). Agreement ([Formula: see text]) with an expert radiologist was assessed for mNY positivity/negativity and individual lesions. Improvements by training strategies were tested by linear mixed models. RESULTS: In exercises I, II, and III, mNY [Formula: see text] were 0.61, 0.76, and 0.84, respectively, in group A; and 0.70, 0.68, and 0.86, respectively, in group B (ie, increasing, mainly after RETIC completion). Improvements were observed for grading both mNY positivity/negativity and individual pathologies, both in experienced and, particularly, inexperienced readers. Completion of the RETIC module in addition to the slideshow and video caused a significant [Formula: see text] increase of 0.17 (95% CI 0.07-0.27; P = 0.002) for mNY-positive and mNY-negative grading, whereas completion of the slideshow and video alone did not ([Formula: see text] = 0.00, 95% CI -0.10 to 0.10; P = 0.99). CONCLUSION: Agreement on scoring radiographs according to the mNY criteria significantly improved when adding an online RETIC module, but not by slideshow and video alone.

• Klíčová slova
• diagnostic imaging, education research, medical education, radiography, radiology, spondyloarthritis,
• MeSH
• axiální spondyloartritida * diagnostické zobrazování   MeSH
• lidé MeSH
• odchylka pozorovatele * MeSH
• radiografie * metody   MeSH
• reprodukovatelnost výsledků MeSH
• sakroiliakální kloub * diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

BACKGROUND: The Spondyloarthritis Research Consortium of Canada (SPARCC) developers have created web-based calibration modules for the SPARCC MRI sacroiliac joint (SIJ) scoring methods. We aimed to test the impact of applying these e-modules on the feasibility and reliability of these methods. METHODS: The SPARCC-SIJ RETIC e-modules contain cases with baseline and follow-up scans and an online scoring interface. Visual real-time feedback regarding concordance/discordance of scoring with expert readers is provided by a colour-coding scheme. Reliability is assessed in real time by intraclass correlation coefficient (ICC), cases being scored until ICC targets are attained. Participating readers (n=17) from the EuroSpA Imaging project were randomised to one of two reader calibration strategies that each comprised three stages. Baseline and follow-up scans from 25 cases were scored after each stage was completed. Reliability was compared with a SPARCC developer, and the System Usability Scale (SUS) assessed feasibility. RESULTS: The reliability of readers for scoring bone marrow oedema was high after the first stage of calibration, and only minor improvement was noted following the use of the inflammation module. Greater enhancement of reader reliability was evident after the use of the structural module and was most consistently evident for the scoring of erosion (ICC status/change: stage 1 (0.42/0.20) to stage 3 (0.50/0.38)) and backfill (ICC status/change: stage 1 (0.51/0.19) to stage 3 (0.69/0.41)). The feasibility of both e-modules was evident by high SUS scores. CONCLUSION: The SPARCC-SIJ RETIC e-modules are feasible, effective knowledge transfer tools, and their use is recommended before using the SPARCC methods for clinical research and tria.

• Klíčová slova
• Magnetic Resonance Imaging, Outcome and Process Assessment, Health Care, Spondylitis, Ankylosing,
• MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• reprodukovatelnost výsledků MeSH
• sakroiliakální kloub * diagnostické zobrazování   patologie   MeSH
• spondylartritida * diagnóza   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Geografické názvy
• Kanada MeSH

BACKGROUND: Sacro-iliac joint (SIJ) pain is an often-misdiagnosed cause (up to 30% cases) of atypical low back pain (LBP) that might be treated with a wide range of conservative interventions. However, Platelet-Rich-Plasma (PRP) ultrasound-guided injections at SIJ level in subjects with mitochondrial disorders have not yet been investigated. CASE PRESENTATION: A 52-year-old Caucasian male with fluoroquinolone-related mitochondrial dysfunction referred to a Physical Medicine and Rehabilitation Outpatient, complaining of severe SIJ pain (Numeric Pain Related Scale, NPRS=8). We performed two bilateral PRP ultrasound-guided injections at the sacro-iliac level. PRP is a simple, efficient, and minimally invasive approach. After the first PRP injection, there was a considerable reduction of pain (NPRS=8 vs 5). The second PRP infiltration was performed after 2 weeks and in both cases no adverse events. At the 6-month follow-up evaluation, the patient showed good physical recovery, with the absence of pain (NPRS=0). CONCLUSION: To the best of our knowledge, this is the first report in the literature assessing the safety and effectiveness of PRP ultrasound-guided injections for SIJ pain in a patient affected by mitochondrial disorders. Thus, this case report might have relevant clinical implications in the treatment of SIJ pain in patients affected by this rare pathological condition, albeit further observational studies are warranted to confirm these findings.

• Klíčová slova
• Platelet-Rich-Plasma, Sacroiliac joint pain, intraarticular injections, pain, rehabilitation,
• MeSH
• artralgie farmakoterapie   etiologie   MeSH
• injekce intraartikulární MeSH
• intervenční ultrasonografie MeSH
• lidé středního věku MeSH
• lidé MeSH
• lumbalgie * farmakoterapie   patologie   MeSH
• měření bolesti MeSH
• pánevní bolest MeSH
• sakroiliakální kloub * diagnostické zobrazování   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH

OBJECTIVE: We present a case and provide an overview of the literature on rare pelvic girdle injury following spontaneous delivery with combined transsymphyseal and transiliosacral instability, its diagnosis and surgical treatment. CASE REPORT: Injury of the pelvic girdle during childbirth is one of the rare obstetric complications. Due to its low prevalence, the standard treatment algorithm is not defined. We present the case of a 27-year-old primipara with a combined separation of the symphysis and sacroiliac joint after spontaneous childbirth, which did not become clinically apparent until several hours later. After the assessment of clinical findings and results of imaging examinations, we indicated the patient for surgical revision due to significant pain syndrome and movement restrictions. Under general anesthesia, we reduced symphysis in an open manner and fixed it with a pelvic plate. We also fixed the injured sacroiliac joint after a closed reduction with a percutaneously inserted iliosacral screw. On the second postoperative day, the patient was mobilized on crutches. On the fourth postoperative day, the patient was discharged from the hospital. The patient was followed up at regular intervals postoperatively. One year after the injury, the pelvic girdle is clinically stable and the patient has no complaints. CONCLUSION: An injury of the pelvic girdle should be considered whenever postpartum patient complains of pain in the area of the symphysis or sacroiliacal joints after natural delivery. In such a case, after a basic imaging diagnosis, a consultation with a specialist with experience in the treatment of pelvic injuries is appropriate. When selecting the most appropriate surgical technique, the nature of injury itself and also early patient mobilisation to be able provide adequate care for her newborn, should be taken into account. Early surgical treatment using stable osteosynthesis helps to address this requirement.

• Klíčová slova
• combined transsymphyseal and transiliosacral instability, peripartal pubic symphysis separation, surgery,
• MeSH
• dospělí MeSH
• lidé MeSH
• novorozenec MeSH
• pánevní kosti * MeSH
• sakroiliakální kloub diagnostické zobrazování   chirurgie   MeSH
• symphysis pubica * diagnostické zobrazování   chirurgie   MeSH
• těhotenství MeSH
• vnitřní fixace fraktury MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

PURPOSE OF THE STUDY Sacroiliac joint dysfunction is defined as a permanent chronic pain originating from the sacroiliac joint, limiting the patient's daily activities. The purpose of this study was to evaluate the effectiveness of the minimally invasive sacroiliac joint stabilization by triangular titanium implants in patients with sacroiliac joint dysfunction. MATERIAL AND METHODS The prospective study evaluated the patients who had underwent a minimally invasive sacroiliac joint stabilization for sacroiliac joint dysfunction with the use of iFuse® implants. The surgery was performed solely under fluoroscopic guidance or together with the use of O-arm O2® mobile imaging system. The clinical condition, the Visual Analogue Scale preoperatively and one year postoperatively, previous surgeries in the lumbar spine region, the use of O-arm and occurrence of complications were recorded. The minimum follow-up period was 1 year. RESULTS The group was composed of 20 patients, of whom 4 men and 16 women. The mean age was 48.9 years. The surgeries covered 21 sacroiliac joints. Improvement of the clinical condition was reported in 17 cases (81.0%), no relief was observed in 4 cases (19%). The mean VAS score was 6.1 points preoperatively and decreased to 2.9 points postoperatively (p=0.0001). CONCLUSIONS The minimally invasive sacroiliac joint stabilization should be reserved for patients experiencing an intractable pain originating from the sacroiliac joint, in whom all non-operative therapy failed. Key words: minimally invasive sacroiliac joint stabilization, sacroiliac joint dysfunction, O-arm.

• MeSH
• chirurgie s pomocí počítače * MeSH
• fúze páteře * MeSH
• lidé středního věku MeSH
• lidé MeSH
• miniinvazivní chirurgické výkony MeSH
• počítačová rentgenová tomografie MeSH
• prospektivní studie MeSH
• sakroiliakální kloub diagnostické zobrazování   chirurgie   MeSH
• zobrazování trojrozměrné MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The purpose of this cross-sectional study was to assess the visfatin levels in patients with axial spondyloarthritis (axSpA) and to investigate the association between visfatin, disease activity and radiographic spinal damage. Serum visfatin levels were determined by enzyme-linked immunosorbent assay in 64 patients with axSpA (46 with radiographic axSpA (r-axSpA) and 18 with non-radiographic axSpA (nr-axSpA)) and 61 age-/sex-matched healthy individuals. Patients with r-axSpA were further divided into two subsets based on radiographic spinal damage using modified Stoke Ankylosing Spondylitis Spine Score (mSASSS = 0 and mSASSS ≥ 1). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to assess disease activity. C-reactive protein (CRP) levels and human leukocyte antigen (HLA)-B27 were determined. Visfatin levels were significantly higher in patients with axSpA and in the subgroup of patients with r-axSpA than in healthy individuals (p = 0.010 and p = 0.005, respectively), with no difference between patients with r-axSpA and with nr-axSpA. In general, disease activity was high (mean BASDAI 5.01) and was moderately correlated with visfatin levels (r = 0.585; p = 0.011) in patients with nr-axSpA. Visfatin levels correlated with mSASSS (r = 0.281; p = 0.026) and were significantly higher in axSpA patients with mSASSS ≥ 1 than in those with mSASSS = 0 (p = 0.025). Our study showed that circulating visfatin levels are elevated in axSpA patients, may be associated with disease activity in early phase of the disease and with the degree of radiographic spinal involvement.

• Klíčová slova
• Axial spondyloarthritis, Disease activity, Radiographic damage, Visfatin,
• MeSH
• bederní obratle diagnostické zobrazování   MeSH
• cytokiny krev   MeSH
• dospělí MeSH
• krční obratle diagnostické zobrazování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nikotinamidfosforibosyltransferasa krev   MeSH
• páteř diagnostické zobrazování   MeSH
• průřezové studie MeSH
• sakroiliakální kloub diagnostické zobrazování   MeSH
• spondylartropatie krev   diagnostické zobrazování   patofyziologie   MeSH
• studie případů a kontrol MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• cytokiny MeSH
• nicotinamide phosphoribosyltransferase, human MeSH Prohlížeč
• nikotinamidfosforibosyltransferasa MeSH

N/A.

• MeSH
• balzamování * MeSH
• formaldehyd * MeSH
• injekce intraartikulární MeSH
• intervenční ultrasonografie * MeSH
• lidé MeSH
• mrtvola MeSH
• sakroiliakální kloub diagnostické zobrazování   MeSH
• výběr pacientů * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH
• Názvy látek
• formaldehyd * MeSH

The case of a 67-year-old woman with a combination of pelvic pyomyositis and left-sided sacroiliitis is reported. After a failed two-week antibiotic therapy, CT-guided percutaneous drainage of psoas muscle abscesses was performed and methicillin-resistant Staphylococcus aureus (MRSA) was isolated. Subsequently, a regression of symptoms was observed. At 6.5 weeks after the onset of symptoms, progression of sacroiliac joint (SI) destruction was again observed and an open revision of the SI joint was indicated (posterior approach, drainage and lavage). This again was followed by symptom regression. At 9.5 weeks after the patient was admitted, her condition markedly deteriorated and a large gluteal abscess was detected on CT examination. The second revision surgery was complicated by massive bleeding and, due to a septic pseudoaneurysm, internal iliac artery ligation was necessary. A significant subsidence of inflammatory changes and no pseudoaneurysm were shown on the follow-up CT scan. The intravenous antibiotic therapy with clindamycin was continued. At follow-up, repeated microbiological cultures from both tissue samples and drained secretions were all negative and CT scanning detected neither any fluid around the SI joint nor a pseudoaneurysm.

• MeSH
• absces psoatu diagnostické zobrazování   chirurgie   MeSH
• antibakteriální látky aplikace a dávkování   MeSH
• arteria iliaca diagnostické zobrazování   chirurgie   MeSH
• drenáž metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• ligace metody   MeSH
• methicilin rezistentní Staphylococcus aureus MeSH
• nepravé aneurysma diagnostické zobrazování   MeSH
• pyomyozitida farmakoterapie   MeSH
• sakroiliakální kloub diagnostické zobrazování   chirurgie   MeSH
• sakroiliitida MeSH
• stafylokokové infekce diagnóza   MeSH
• Staphylococcus aureus izolace a purifikace   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• antibakteriální látky MeSH

Pelvic fractures in children are relatively rare, especially unstable pelvic ring disruptions. Generally, nonoperative treatment has been recommended for children with these injuries because healing is rapid and remodeling extensive in children. Treatment generally is a period of recumbency until the fractures heal, followed by gradual weight bearing. Various methods of operative treatment were advised by some authors. They reported a higher incidence of residual problems after pelvic disruption such as malunion, hemipelvic undergrowth, low back pain and leg length discrepancy. These authors are of opinion, that principles of treatment should not differ from the treatment of adults if the pelvis is unstable and if there is significant displacement. We describe a case of a vertically unstable pelvic ring injury with sacroiliac joint dislocation and limb length discrepancy in 11 year old boy. Patient was received for treatment 14 days after trauma. He was treated by open reduction from anterior approach and percutaneous screw fixation. In one year follow-up he has very good functional result.

• MeSH
• dislokace kloubu diagnostické zobrazování   chirurgie   MeSH
• dítě MeSH
• lidé MeSH
• radiografie MeSH
• sakroiliakální kloub diagnostické zobrazování   zranění   chirurgie   MeSH
• vnitřní fixace fraktury * MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH