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Sacroiliac joint tuberculosis.

R J S Ramlakan1, S Govender

  • 1Spinal Unit, King George V Hospital, University of Kwa-Zulu Natal, Durban, South Africa. ramlakan@ukzn.ac.za

International Orthopaedics
|May 5, 2006
PubMed
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Tuberculosis sacroiliitis is a rare cause of low back pain, often diagnosed late. Early detection and 18-month treatment with medication led to spontaneous sacroiliac joint fusion and improved mobility.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Radiology

Background:

  • Sacroiliac joint infections are uncommon, leading to diagnostic delays.
  • Tuberculosis sacroiliitis presents with symptoms like low back pain and gait disturbance.
  • Associated findings can include buttock abscess and lumbar spondylitis.

Purpose of the Study:

  • To review the clinical presentation, diagnosis, and treatment outcomes of tuberculosis sacroiliitis.
  • To highlight the importance of considering sacroiliac joint infections in differential diagnoses.
  • To evaluate the long-term effects of treatment on joint function.

Main Methods:

  • Retrospective review of 17 patients treated for tuberculosis sacroiliitis (1994-2004).
  • Clinical evaluation including Gaenslen's and FABER tests.

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  • Radiological assessment, open biopsy, curettage, and histological analysis.
  • Treatment with 18 months of antituberculous medication.

    • Main Results:

    • Low back pain and walking difficulties were primary symptoms.
    • Histology confirmed chronic infection with acid-fast bacilli in 9/15 patients.
    • Radiological changes showed joint erosion and loss of cortical margins.
    • Spontaneous sacroiliac joint fusion occurred within 2 years post-treatment.
    • Patients reported mild residual low back discomfort but no gait impairment.

    Conclusions:

    • Tuberculosis sacroiliitis requires inclusion in the differential diagnosis for low back pain.
    • Meticulous patient history and clinical examination are crucial for early diagnosis.
    • Effective treatment with antituberculous medication promotes joint fusion and functional recovery.