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Pyogenic sacroiliitis in a rural population
R A Moyer1, J E Bross, T M Harrington
1Department of Rheumatology, Geisinger Medical Center, Danville, PA 17822.
The Journal of Rheumatology
|October 1, 1990
Summary
Pyogenic sacroiliitis, a bacterial joint infection, can affect young adults without intravenous drug use history. Pelvic trauma is a significant risk factor, with Staphylococcus aureus being the most common pathogen.
Area of Science:
- Infectious Diseases
- Orthopedics
- Radiology
Background:
- Pyogenic sacroiliitis is a rare but serious infection affecting the sacroiliac joints.
- This study investigates cases within a rural demographic, differing from typical urban populations often associated with intravenous drug use.
Observation:
- Ten cases of pyogenic sacroiliitis were identified in a rural population, predominantly affecting young males (mean age 22.4 years).
- A history of recent pelvic trauma was noted in 50% of patients.
- None of the patients were recent intravenous drug abusers.
Findings:
- 99mTechnetium scintiscans demonstrated increased sacroiliac (SI) joint uptake in 8 of 8 evaluated cases.
- Blood cultures yielded positive results in 60% of patients.
- Staphylococcus aureus was the most frequently isolated pathogen (7 cases), with one case involving Hemophilus influenzae type B.
Implications:
- The findings suggest pyogenic sacroiliitis can occur in young adults without typical risk factors like intravenous drug use, highlighting pelvic trauma as a key consideration.
- Early diagnosis aided by scintiscans and prompt treatment led to favorable outcomes, with 90% of patients recovering completely.
- This underscores the importance of considering pyogenic sacroiliitis in the differential diagnosis of hip and back pain, particularly in younger individuals with relevant trauma history.