Sacro-Iliitis And Salpingitis: Quantitative99mTc Pertechnetate Scanning in the Study of Sacro-iliitis in Women

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Abstract
Fifty-seven women who had been admitted to hospital for severe acute salpingo-oophoritis between June 1974 and June 1976 and 31 gynaecologically healthy controls were examined for die occurrence of sacro-iliitis (SI); 42 of them were examined by quantitative 99mTc pertechnetate scanning of the sacroiliac Joints (QTPS). The QTPS index was abnormally elevated in 34. Only one of the controls recorded an abnormal QTPS index. The radiographs of the salpingitis group showed definite SI in 15, probable SI in 26, and signs of inactive SI in one patient, while 15 had no abnormalities suggestive of the disease. There was a significant correlation between the radiographic stage and the QTPS index. On the basis of the QTPS index values, 2 patients without radiographic changes suggestive of SI were considered to have the disease, and 3 patients with probable SI were classed as displaying no manifest inflammation. Accordingly, the incidence of SI was 39 out of 57, or 68%, for the salpingitis group, against 1 out of 31 (3%) for the control group. There was no significant difference in the presence of HLA-B27 antigen in the two groups. At a follow-up gynaecological examination of the 57 women, chronic salpingitis was found hi 8, cervicitis in 8, and growth of micro-organisms in 23. All but one of the control subjects were gynaecologically normal. Anaerobic bacteria of unspecified types were found in 37 % of the salpingitis series and in 3 % of the controls. Radiographic and/or nucleographk SI, a relatively low frequency of HLA-B27 antigen and low-back symptoms of mild degree, if any, were characteristic of the salpingitis group. It would seem that there is a strong positive correlation between the occurrence of severe salpingitis and SI. QTPS would appear to be a sensitive and safe technique for the detection of disease of the sacroiliac joint.