Magnetic resonance imaging of the sacroiliac joints
Sacroiliac Joint MRI in Casablanca
The sacroiliac joints connect the sacrum, at the base of the spine, to the two iliac bones of the pelvis. Sacroiliac joint MRI examines these two joints, without X-rays, and can show inflammation of the bone around them long before X-rays do. It is mainly requested for inflammatory-type pain in the lower back or buttocks, especially when a rheumatic disease such as spondyloarthritis is being considered.
Duration, report and equipment
Duration
Sacroiliac joint MRI usually takes 20 to 30 minutes, a little longer if the spine is also examined.
Report turnaround
Report within 48 hours. In an emergency, during opening hours, the report is handed over immediately.
Equipment
GE SIGNA Prime 1.5 T
When is this exam needed?
- Lower back or buttock pain that wakes you at night, with morning stiffness, in young adults.
- Suspected sacroiliitis (inflammation of a sacroiliac joint) as part of spondyloarthritis.
- Monitoring inflammation in a known rheumatic disease under treatment.
- Severe buttock pain with fever, raising the possibility of a joint infection.
- Suspected stress fracture of the sacrum, in female runners, after childbirth or with osteoporosis.
- Persistent sacroiliac pain after an injury or a pregnancy.
How the exam is done
You remove your metal objects, including your belt, then lie on your back with a cushion under your knees to relieve your lower back. A coil is placed flat on your pelvis, in addition to the one built into the table under your lower back. The slices are oriented along the axis of the sacrum, in the plane of the joints, which requires a straight and symmetrical position.
The noisy sequences are done with headphones. Some series look for bone edema (a build-up of water that reflects inflammation), others show the structure of the joint and any erosions. Stay still, with your hands on your chest or along your body. If your doctor has requested it, the exam can be extended with images of the spine. You then get up gently.
Preparation
- Empty your bladder before the exam so you can lie down comfortably.
- If pain prevents you from staying on your back, tell the team so the cushions can be adjusted.
- Write down the treatments you have received for your rheumatic condition (anti-inflammatories, biologic therapy) and their dates, which are useful for interpreting the inflammation.
Fasting
No fasting is required for a sacroiliac joint MRI; you can have breakfast and take your medications.
Contrast injection
Most often, the exam is done without an injection, as dedicated sequences are enough to show inflammation. The radiologist may sometimes inject gadolinium into a vein, especially if an infection is suspected.
Contraindications and precautions
- Pacemaker or defibrillator: only verified MRI compatibility allows the exam.
- Spinal cord stimulator (for pain), cochlear implant, implanted drug pump, old clip on an artery.
- Metal foreign body, especially in the eye.
- Sacroiliac screws or hardware placed on the pelvis or spine: please tell us.
- Insulin pump or glucose sensor (such as FreeStyle Libre): to be removed before the exam. Bring what you need to replace it or put it back afterwards.
- Current or possible pregnancy: please tell us. MRI is performed only if it is necessary, preferably after the first trimester, and without gadolinium unless absolutely necessary.
- Breastfeeding: please tell us. It is generally not necessary to stop breastfeeding after a gadolinium injection.
- If an injection is being considered, tell us about severe kidney disease; also tell us about tattoos, permanent makeup and claustrophobia.
Documents to bring
- Prescription from the rheumatologist or family doctor.
- X-rays of the pelvis or sacroiliac joints, and previous MRIs or CT scans for comparison.
- Recent blood test results (inflammation markers, HLA-B27 typing if it has been done).
- List of your treatments, especially anti-inflammatories and biologic therapies.
- Insurance or mutual insurance fund card.
Price and insurance coverage
The price of a sacroiliac joint MRI varies depending on any extension to the spine during the same session and on a gadolinium injection, which is rarely necessary.
The center accepts coverage from insurance companies and the main mutual insurance funds. You submit the coverage request to your insurer or fund yourself. For AtlantaSanad and Sanlam, the center takes care of it.
No prices are shown on this site: Kenza gives you the exact price on WhatsApp, along with the coverage procedure for your situation.
Frequently asked questions
Why an MRI and not just an X-ray of the pelvis?
On an X-ray, sacroiliitis often appears only after months or years, when the bone has already changed. MRI can show bone edema, a sign of active inflammation, much earlier. It thus helps the rheumatologist with the diagnosis and with monitoring how well the treatment works.
Should I stop my anti-inflammatories before the MRI?
Never change your treatment on your own. Some rheumatologists prefer to do the MRI before starting treatment, because anti-inflammatories can reduce the signs of inflammation visible on the images. Ask the doctor who prescribed the exam, who will decide based on your situation.
Does a normal MRI rule out spondyloarthritis?
Not always. The diagnosis is based on a combination of elements: symptoms, clinical examination, blood tests, response to anti-inflammatories and imaging. An MRI with no abnormality at a given time does not exclude a disease in its early stage. Your rheumatologist may request a new check if symptoms persist.
Why also examine the spine?
Spondyloarthritis can affect both the sacroiliac joints and the spine. Depending on your doctor's request, additional images of the spine can be taken during the same session to look for inflammation of the vertebrae. This makes the exam a little longer but avoids a second appointment.
Sacroiliac Joint MRI in Casablanca: how much does it cost?
The price of a sacroiliac joint MRI varies depending on any extension to the spine during the same session and on a gadolinium injection, which is rarely necessary. The center accepts coverage from insurance companies and the main mutual insurance funds. No prices are shown on this site: Kenza gives you the exact price on WhatsApp, along with the coverage procedure for your situation.