Clinical features and surgical management of tuberculous arthritis of the sacroiliac joint: a retrospective analysis of 33 patients

Abstract

Background We reviewed 3 different types of tuberculous sacroiliitis via anterior and posterior approaches to determine the efficacy and safety of this surgical approach by describing clinical presentation, imaging, and surgical treatment. Methods We reviewed 33 patients with 3 different types of severe tuberculous sacroiliitis, of which 16 patients with anterior iliac abscess underwent anterior debridement. 17 patients underwent posterior debridement. Among them, 5 patients with lumbar tuberculosis underwent lesion debridement through fenestration, joint fusion, and interbody fusion and internal fixation. The mean postoperative follow-up was 16.9 months (12–25 months).Erythrocyte sedimentation rate (ESR), visual analogue scale (VAS) and the Oswestry Disability Index (ODI) were used to judge the postoperative condition and functional recovery. Results All patients’ hip, back and lower back pain symptoms were significantly relieved after surgical treatment. At 3 months after operation, the VAS and ODI scores of all patients decreased significantly. Conclusion Surgical treatment of tuberculous sacroiliitis should be performed as soon as possible under the adjuvant chemotherapy of anti-tuberculosis drugs. According to the different characteristics of sacroiliac joint tuberculosis, appropriate surgical operations should be adopted according to our classification criteria.

Radiological Insights into Sacroiliitis: A Narrative Review

“…Additionally, the prevalence of chronic sacroiliitis seems to be higher in patients with familial mediterranean fever (FMF) compared to the general population [ 1 ]. Furthermore, although its incidence is low, tuberculosis can penetrate into the cancellous bone and joint synovium and cause tuberculous sacroiliitis [ 42 ].…”

“…Many studies revealed techniques that offer high-resolution imaging, which can aid in the early detection and assessment of disease activity [ 42 ]. Among these techniques is dual energy-computed tomography (CT), which differs from conventional CT in that it involves the attainment of images at two different energy levels; therefore, it can differentiate between parts with high and low atomic numbers [ 73 , 74 ].…”