[Pyogenic sacroiliitis in children. Apropos of 11 cases]

Sacroiliitis in children is a rare disease. Since 1878, only 100 cases have been reported in the international literature.

We reviewed a series of 11 cases (mean age of 7.75 years) with a delay of 45 months. All the patients had limp, and hip pain.

The clinical examination found each time F.A.B.E.R.E. and Glaensen signs. The hip mobility was limited most of time. There was a non specific inflammatory syndrome. Roentgenogram signs were delayed, and associated widening of the joint, geodes, condensation, and at an ultimate stage, fusion of the joint. Tc 99m scintigraphy always showed the localisation.

This examination shortened the diagnosis delay, C-T scan was performed twice. It allowed visualize the local extension and complication such as abscess. It facilitated the indication of the surgical approach, and results can be appreciated through follow up CT scan studies. The germ was rarely determined as it has been reported in the literature. Therefore an articular ponction must be performed each time a sacroiliitis is suspected, under general anesthesia and associated to an arthrography or under CT scan control. Surgical drains were placed five times only. The authors limited their indication to an important collection, an abscess, or an intra-articular sequestra.

At the maximum follow up (mean 45 months) all patients had a normal clinical exam. Each time there were joint modification on the roentgenogramm but without any functional correlation.