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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
PubMed
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.

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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.

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