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Septic sacroiliitis

A A Osman1, S Govender

  • 1Department of Orthopaedic Surgery, Faculty of Medicine, University of Natal, Congella, South Africa.

Clinical Orthopaedics and Related Research
|April 1, 1995
PubMed
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Septic arthritis of the sacroiliac joint, often caused by tuberculosis or staphylococcal infections, presents with vague symptoms like buttock pain. Most patients recover with conservative treatment, including antibiotics and rest.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Rheumatology

Background:

  • Septic arthritis of the sacroiliac joint is a rare condition.
  • It often presents with vague and nonspecific symptoms, making diagnosis challenging.
  • Common causative agents include tuberculosis, Staphylococcus aureus, Neisseria gonorrhoeae, and Salmonella Typhi.

Purpose of the Study:

  • To describe the clinical presentation, diagnostic methods, and treatment outcomes of septic arthritis of the sacroiliac joint.
  • To highlight the challenges in diagnosing this condition due to its nonspecific symptoms.
  • To evaluate the effectiveness of conservative management versus surgical intervention.

Main Methods:

  • Retrospective analysis of 31 patients diagnosed with septic arthritis of the sacroiliac joint.

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  • Review of clinical presentations, diagnostic workup (including bone scans, hematologic investigations, blood cultures, and arthrocentesis), and treatment regimens.
  • Categorization of patients based on causative pathogens: tuberculosis, staphylococcal, gonococcal, and typhoid.

    • Main Results:

    • The most common symptoms were buttock pain, low back pain, and difficulty walking.
    • Diagnosis was established through clinical examination, imaging, and laboratory tests in most patients.
    • Twenty-nine out of 31 patients improved with conservative treatment (bed rest and antibiotics).
    • Two patients with tuberculosis sarcoiliitis required open drainage for large buttock abscesses.

    Conclusions:

    • Septic arthritis of the sacroiliac joint requires a high index of suspicion due to its nonspecific presentation.
    • Early diagnosis and prompt treatment, often conservative, lead to favorable outcomes.
    • Surgical intervention may be necessary in complicated cases, such as those with large abscesses secondary to tuberculosis.