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Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review

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Septic sacroiliitis in children.

Akifusa Wada¹, Kazuyuki Takamura, Toshio Fujii

¹Department of Orthopaedic Surgery, Fukuoka Children's Hospital, Fukuoka, Japan. wada.a@fukuoka-child.jp

Journal of Pediatric Orthopedics

|June 4, 2008

Summary

Septic sacroiliitis in children is often misdiagnosed due to varied symptoms and negative initial X-rays. Magnetic resonance (MR) imaging is crucial for diagnosis, and while antibiotic treatment improves clinical signs, bone marrow signal changes on MR may persist post-therapy.

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Area of Science:

Pediatric Infectious Diseases
Musculoskeletal Imaging
Rheumatology

Background:

Septic sacroiliitis is a rare but serious infection affecting the sacroiliac joints.
Early diagnosis is challenging due to non-specific symptoms and often normal initial radiographic findings.
Misdiagnosis can lead to delayed treatment and potential long-term complications.

Purpose of the Study:

To review the clinical, laboratory, and magnetic resonance (MR) imaging features of pediatric septic sacroiliitis.
To highlight diagnostic challenges and the role of MR imaging in confirming the condition.
To evaluate treatment response and imaging follow-up findings.

Main Methods:

Retrospective review of 8 pediatric patients diagnosed with septic sacroiliitis.
Analysis of clinical presentations, laboratory results, and MR imaging findings.
Assessment of treatment outcomes including clinical, laboratory, and serial MR imaging.

Main Results:

All 8 patients presented with diverse symptoms (hip, back, knee, abdominal pain) and were initially misdiagnosed.
Magnetic resonance (MR) imaging was essential for accurate diagnosis in all cases.
While clinical and laboratory parameters improved with antibiotics, MR imaging showed persistent bone marrow signal changes for 2-3 months post-treatment.

Conclusions:

Septic sacroiliitis in children requires a high index of suspicion due to its varied clinical presentation.
Magnetic resonance (MR) imaging is the gold standard for diagnosing pediatric septic sacroiliitis.
Persistent bone marrow signal abnormalities on MR imaging after treatment are common and should not be mistaken for ongoing infection.