Acute pyogenic sacroiliitis without predisposing conditions.

Abstract:

STUDY DESIGN:Clinical and imaging findings of patients diagnosed with pyogenic sacroiliitis were retrospectively analyzed. OBJECTIVES:To characterize the clinical and magnetic resonance features of patients with acute pyogenic sacroiliitis without the usually known predisposing conditions and to investigate the diagnostic value of magnetic resonance imaging in detecting the early stages of pyogenic sacroiliitis. SUMMARY OF BACKGROUND DATA:Pyogenic sacroiliitis is relatively uncommon, and accurate diagnosis is frequently delayed due to lack of awareness by clinicians and nonspecific clinical presentation. There have been few reports that have evaluated the clinical features of acute pyogenic sacroiliitis and investigated the diagnostic capabilities of magnetic resonance imaging in detecting pyogenic sacroiliitis in the early stages. METHODS:The clinical data of 9 patients (6 male, 3 female; average age 27.3 years) diagnosed with acute pyogenic infection of the sacroiliac joint were retrospectively analyzed. Magnetic resonance images as well as computed tomography of the sacroiliac joints were available in all cases. Seven of the patients underwent 99mtechnetium bone scans. RESULTS:All patients showed positive findings on magnetic resonance images, whereas 99mtechnetium bone scans were positive in six of seven patients. Eight patients responded well to treatment with intravenous antibiotic therapy, whereas one patient required debridement of the sacroiliac joint following conservative treatment. CONCLUSIONS:Both magnetic resonance imaging and technetium bone scanning are sensitive for localizing occult sites of bone inflammation. Magnetic resonance imaging may provide more useful information than bone scanning by screening for abnormalities in the sacroiliac joint region. With prompt appropriate antibiotic therapy, clinical improvement of patients can be expected.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Doita M,Yoshiya S,Nabeshima Y,Tanase Y,Nishida K,Miyamoto H,Watanabe Y,Kurosaka M

doi

10.1097/01.BRS.0000092481.42709.6F

keywords:

subject

Has Abstract

pub_date

2003-09-15 00:00:00

pages

E384-9

issue

18

eissn

0362-2436

issn

1528-1159

journal_volume

28

pub_type

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