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Sacroiliitis - it's not all B 27.

M Backhaus1, T Kamradt, D Loreck

  • 1Department of Rheumatology, Charité University Hospital, Humboldt-University of Berlin, Schumannstrasse 20/21 D-10117 Berlin, Germany.

Zeitschrift Fur Rheumatologie
|September 29, 1999
PubMed
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We present a case of unilateral sacroiliitis in an HLA-B27 positive patient, which resulted in joint ankylosis without typical spondyloarthropathy signs. This case highlights the differential diagnosis of unilateral sacroiliitis.

Area of Science:

  • Rheumatology
  • Immunogenetics

Background:

  • Sacroiliitis, inflammation of the sacroiliac joints, is a key feature of ankylosing spondylitis (AS).
  • Ankylosing spondylitis typically presents with bilateral sacroiliitis.
  • The human leukocyte antigen B27 (HLA-B27) gene is strongly associated with spondyloarthropathies.

Observation:

  • A case of pyogenic sacroiliitis following trauma in an HLA-B27 positive individual is described.
  • The patient developed complete unilateral sacroiliac joint ankylosis.
  • No clinical or radiological signs of HLA-B27 associated spondyloarthropathy were present.

Findings:

  • Post-traumatic pyogenic sacroiliitis can lead to unilateral sacroiliac joint ankylosis.
  • Unilateral sacroiliitis may occur in HLA-B27 positive individuals without overt spondyloarthropathy.

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  • The presentation differs from the typical bilateral sacroiliitis seen in ankylosing spondylitis.

    • Implications:

    • This case broadens the understanding of sacroiliitis presentations in HLA-B27 positive individuals.
    • It underscores the importance of considering pyogenic infections in the differential diagnosis of unilateral sacroiliitis.
    • Further research may clarify the relationship between trauma, infection, HLA-B27, and sacroiliitis development.