Infantile infectious sacroiliitis

Abstract

Two infants with pyogenic sacroiliitis are presented. In both babies, the clinical findings were initially attributed to septic arthritis of the ipsilateral hip. The correct diagnosis was not established in either infant until radionuclide scanning showed increased uptake in the ipsilateral sacroiliac joints. Both cases emphasize the importance of proceeding quickly to radionuclide imaging in the baby with clinical and laboratory findings of inflammation in the vicinity of the hip and a negative hip aspiration.

Acute Pyogenic Sacroiliitis Without Predisposing Conditions

“…Although uncommon, early recognition of pyogenic sacroiliitis is important because delayed diagnosis results in increased morbidity. 6,[22][23][24] The presentation is often diverse, with symptoms and examination findings often suggestive of more common pathologies such as septic arthritis of the hip, lumbar disc herniation, or pelvic abscess. In the present series, the correct diagnosis was initially suspected in only four pa- tients on admission.…”

Myofascial Trigger Points in the Ipsilateral Gluteal Muscles Associated with Pyogenic Sacroiliitis: A Case Report

“…Pyogenic sacroiliitis is a relatively rare infection and is usually overlooked in initial diagnostic attempts (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). In 1990, Vyskocil et al (5) reviewed 166 cases of pyogenic sacroiliitis in the English litera- ture from 1878 to 1990.…”

“…Pyogenic sacroiliitis is a relatively rare condition and is often diagnosed late because of poor localization of symptoms, various manifestations, and normal plain radiographs at presentation (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Clinical manifestations may be misleading and mimic a myopathy (1), acute abdomen (2), herniated intervertebral disc [HIVD] with radiculopathy [sciatica] (3,4,13), or septic hip (3,9,11).…”

“…Clinical manifestations may be misleading and mimic a myopathy (1), acute abdomen (2), herniated intervertebral disc [HIVD] with radiculopathy [sciatica] (3,4,13), or septic hip (3,9,11). Clinical symptoms of pyogenic sacroiliitis includes back pain, buttock pain, and radiating pain to the thigh and leg of the involved side (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Tenderness in the gluteal area could be due to myofascial trigger points [MTrPs] in the gluteal muscles or piriformis muscle (11).…”

Pyogenic sacroiliitis in a 14-year-old girl

“…Symptoms may also be diffuse and bilateral or mimic septic arthritis of the hip, sciatica or even an acute abdomen [4]. This confusing presentation can be explained by differences in the innervation to the sacroiliacal (SI) joint and the route of local extension of the inflammation [7]. Physical examination alone is often not adequate to distinguish PS from muscular pain, pelvic fracture, disc disease or an intraabdominal process.…”