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The "warm" sacroiliac joint. A finding in pelvic abscess
J D Slavin1, N Epstein, J A Negrin
1Department of Radiology, Saint Francis Hospital and Medical Center, Hartford, Connecticut.
Clinical Nuclear Medicine
|September 1, 1990
Summary
Asymmetric sacroiliac joint uptake on bone scans may indicate pelvic abscesses, not osteomyelitis. Early antibiotic treatment and drainage led to rapid recovery in two patients.
Area of Science:
- Radiology
- Nuclear Medicine
- Infectious Disease
Background:
- Sacroiliac joint pain can be challenging to diagnose.
- Bone scintigraphy and Gallium-67 (Ga-67) imaging are used to evaluate inflammatory conditions.
Observation:
- Two patients presented with low back and sacroiliac pain.
- Bone scans showed asymmetric "warmth" in one sacroiliac joint.
- Ga-67 imaging revealed increased uptake in the same region.
Findings:
- CT scans identified pelvic abscesses adjacent to the affected sacroiliac joints.
- Asymmetric uptake on imaging may be due to hyperemia of the sacroiliac joint.
- Absence of CT evidence of bone involvement and rapid clinical improvement suggested no osteomyelitis.
Implications:
- Asymmetric sacroiliac joint uptake on bone scans can be an early sign of pelvic abscess.
- This finding necessitates further investigation with CT to rule out or confirm abscess.
- Prompt antibiotic therapy and drainage are crucial for managing pelvic abscesses and avoiding misdiagnosis of osteomyelitis.