Analysis of clinical and imaging characteristics of infectious sacroiliac arthritis and review of literatures / 中华内科杂志

ABSTRACT

Objective To study the clinical and imaging characteristics of patients with infectious sacroiliac arthritis.Method Twenty-one patients diagnosed with infectious sacroiliac arthritis were analyzed retrospectively between 2000 and 2014.The chief complaint was pain in hip and lumbosacral area.Their clinical features,laboratory tests and pathological examination results as well as CT/MRI/PET-CT images were evaluated.Results There were nine males and thirteen females eighteen (85.7％) patients had unilateral sacroiliac joint involvement.Among these patients,three were diagnosed with brucellosis sacroiliac arthritis(BSI),eight patients with tuberculosis sacroiliac arthritis (TSI),and ten patients with non-brucellosis and non-tuberculosis infectious sacroiliac arthritis (ISI).For those patients with non-brucellosis and non-tuberculosis infectious sacroiliac arthritis,white blood cell count,erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)were dramatically increased.Twelve patients were diagnosed pathologically including 6 ISI,2 BSI and 4 TSI.Twelve patients and seventeen patients were scanned by CT and MRI respectively.Two patients undertook PET-CT examination.Antibiotic therapy showed significant therapeutic effects in all patients.Conclusion Infectious sacroiliac arthritis patients with hip or lumbosacral pain as the chief complaint can be easily misdiagnosed as spondyloarthritis.Comprehensive analysis of clinical features,imaging and laboratory findings is essential for accurate diagnosis.