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Tuberculous sacroiliitis. Four cases.
Mohammed Benchakroun1, Ahmed El Bardouni, Omar Zaddoug
1Trauma and Orthopedics Unit, Avicenne Teaching Hospital, 36, rue Robinia, Sector 24, G7, Hay Riad, Rabat 10100, Morocco. benchakrounmohammed@hotmail.com
Joint Bone Spine
|March 31, 2004
Summary
This study details tuberculous sacroiliitis, a rare joint tuberculosis variant. Early diagnosis and antitubercular treatment are crucial for restoring joint function before significant damage occurs.
Area of Science:
- Infectious Diseases
- Rheumatology
- Orthopedics
Background:
- Tuberculous sacroiliitis is an uncommon form of musculoskeletal tuberculosis.
- It often presents without systemic signs or involvement of other organs, complicating diagnosis.
Purpose of the Study:
- To describe the clinical and radiological features of tuberculous sacroiliitis.
- To highlight diagnostic challenges and treatment outcomes in this specific patient group.
Main Methods:
- Retrospective case series of four patients diagnosed with tuberculous sacroiliitis.
- Histopathological examination of surgical biopsies and microbiological culture (Lowenstein-Jensen medium) for Mycobacterium tuberculosis.
- Clinical follow-up assessing response to antitubercular therapy and physical rehabilitation.
Main Results:
- Four patients (3 males, 1 female, mean age 42) presented with slowly progressive tuberculous sacroiliitis.
- Diagnosis was delayed (mean 14 months) due to lack of other tuberculous sites.
- Biopsies confirmed granulomatous inflammation with caseous necrosis; tubercle bacilli were cultured.
- All patients responded to antitubercular drugs and protected weight-bearing.
Conclusions:
- Tuberculous sacroiliitis without other sites is a diagnostic challenge due to its insidious onset.
- Prompt antitubercular treatment is effective in preserving joint function if initiated before extensive radiological damage.