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Pyogenic sacroiliitis--a comparison between paediatric and adult patients
1Department of Emergency Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, Taiwan.
Insights
Pyogenic sacroiliitis, a rare hip pain cause, presents differently in children and adults. This study highlights key distinctions in symptoms, infections, and pathogens between pediatric and adult cases.
Area of Science:
- Infectious Diseases
- Pediatric Rheumatology
- Radiology
Background:
- Pyogenic sacroiliitis is an uncommon condition causing hip pain and fever.
- This study reviews 33 cases to differentiate pediatric and adult presentations.
Purpose of the Study:
- To report a series of pyogenic sacroiliitis cases.
- To investigate and compare differences between pediatric and adult patients.
Main Methods:
- Retrospective analysis of 33 patients diagnosed with pyogenic sacroiliitis (1996-2005).
- Patients were categorized into pediatric (≤15 years) and adult groups.
- Comparison of clinical, laboratory, and imaging features, including gender, symptoms, comorbidities, and pathogens.
Main Results:
- Females were more frequently affected (3:1 ratio).
- Concurrent infections, particularly urinary tract infections, were noted in one-third of patients.
- Pediatric patients showed fewer comorbidities and infections, more gender balance, and greater weight-bearing difficulty compared to adults.
- Staphylococcus aureus was the primary pathogen in pediatric cases; adults had a broader range including Group B Streptococcus and Salmonella spp.
- Scintigraphic bone scan demonstrated high sensitivity (93.3%) for diagnosis; CT/MRI are useful for suspected abscesses.
Conclusions:
- Physicians should consider pyogenic sacroiliitis in differential diagnoses.
- Recognizing the distinct features in pediatric versus adult populations is crucial for appropriate management.
Background:
Pyogenic sacroiliitis is a rare cause of hip pain and fever. We aim to report a series of 33 patients with pyogenic sacroiliitis and to investigate the differences among paediatric and adult cases.
Methods:
Clinical and laboratory data of 33 cases who were admitted to the emergency department with a confirmed discharge diagnosis of pyogenic sacroiliitis between 1996 and 2005 were assessed. All patients were divided into paediatric and adult groups by the age of 15 yr. The features of pyogenic sacroiliitis and clinical outcome were compared among the two groups. Several factors were analysed including gender, age, clinical signs and symptoms, laboratory tests, radiological examinations and scintigraphy.
Results:
Among the all included patients, females were attacked more frequently than males (3: 1). One-third of patients had concurrent infections, of which urinary tract infections were the most common (41.6%). Compared with adult patients, paediatric patients tend to have fewer comorbid immunocompromized conditions, fewer concurrent infections, more equality in gender distribution and more presentations of weight bearing difficulty. Staphylococcus aureus was the main blood culture isolate from paediatric patients (80%), but only accounted for half of those from adult patients. Group B streptococcus and Salmonella spp. were not uncommon in the adult patients. Scintigraphic bone scan has the highest sensitivity (93.3%) and remains the image modality of choice. When local abscess formation is suspected, computed tomography or magnetic resonance imaging may be the preferred method used for examination.
Conclusion:
This case series should alert the physicians to the possibility of pyogenic sacroiliitis and the difference between paediatric and adult patients.
