STIR sequence in infectious sacroiliitis in three patients

Bellussi, A; Rizzi, Elisa Busi; Schininà, Vincenzo; Santis, Andrea De; Bibbolino, Corrado

doi:10.1016/s0899-7071(01)00407-7

Cited by 20 publications

(13 citation statements)

References 7 publications

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“…Although CT scans provide an accurate assessment of the bone structure, they may confuse the diagnosis. In our study, CT scans were normal in 22.4% of cases when performed early [21], although they may be used while performing a biological procedure ( i . e ., biopsy, arthrocentesis, drainage).…”

Section: Discussionmentioning

confidence: 89%

Infectious sacroiliitis: a retrospective, multicentre study of 39 adults

et al. 2012

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BackgroundNon-brucellar and non-tuberculous infectious sacroiliitis (ISI) is a rare disease, with misleading clinical signs that delay diagnosis. Most observations are based on isolated case reports or small case series. Our aim was to describe the clinical, bacteriological, and radiological characteristics of ISI, as well as the evolution of these arthritis cases under treatment.MethodsThis retrospective study included all ISI cases diagnosed between 1995 and 2011 in eight French rheumatology departments. ISI was diagnosed if sacroiliitis was confirmed bacteriologically or, in the absence of pathogenic agents, if clinical, biological, and radiological data was compatible with this diagnosis and evolution was favourable under antibiotic therapy.ResultsOverall, 39 cases of ISI were identified in adults, comprising 23 women and 16 men, with a mean age at diagnosis of 39.7 ± 18.1 years. The left sacroiliac joint (SI) was affected in 59% of cases, with five cases occurring during the post-partum period. Lumbogluteal pain was the most common symptom (36/39). Manipulations of the SI joint were performed in seven patients and were always painful. Mean score for pain using the visual analogue score was 7.3/10 at admission, while 16 patients were febrile at diagnosis. No risk factor was found for 30.7% of patients. A diagnosis of ISI was only suspected in five cases at admission. The mean time to diagnosis was long, being 43.3 ± 69.1 days on average. Mean C-reactive protein was 149.7 ± 115.3 mg/l, and leukocytosis (leukocytes ≥ 10 G/l) was uncommon (n = 15) (mean level of leukocytes 10.4 ± 3.5 G/l). Radiographs (n = 33) were abnormal in 20 cases, revealing lesions of SI, while an abdominopelvic computed tomography (CT) scan (n = 27) was abnormal in 21 cases, suggesting arthritis of the SI joints in 13 cases (48.1%) and a psoas abscess in eight. Bone scans (n = 14) showed hyperfixation of the SI in 13 cases. Magnetic resonance imaging (MRI) (n = 27), when focused on the SI (n = 25), directed towards the diagnosis to ISI in 25 cases. Pathogenic agents were isolated in 33 cases (84.6%) by means of articular puncture (n = 16), blood culture (n = 14), cytobacteriological examination of urine (n = 2), or puncture of the psoas (n = 1).Gram-positive cocci were the mostly isolated common bacteria, with a predominance of staphylococci (n = 21). The most frequently isolated gram-negative bacillus was Pseudomonas aeruginosa (n = 3). Evolution was favourable in 37 out of 39 patients under prolonged antibiotic therapy (mean duration 3.01 ± 1.21 months).ConclusionOur series confirmed that the clinical manifestations of ISI usually lead to delayed diagnosis. Based on our results, we suggest performing an MRI of the spine and SI in clinical situations characterised by lumbogluteal pain and symptoms of an infectious disease, such as fever.

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Section: Discussionmentioning

confidence: 89%

Infectious sacroiliitis: a retrospective, multicentre study of 39 adults

et al. 2012

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“…[22][23][24][25][26][27] Radiographs tend to be normal in the first 2 weeks of a sacroiliitis infection when MRI often reveals abnormalities. [22][23][24][25][26][27] Radiographs tend to be normal in the first 2 weeks of a sacroiliitis infection when MRI often reveals abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Economic Impact of the Community-Acquired Methicillin-Resistant Staphylococcus Aureus Epidemic on the Driscoll Children's Health Plan

Purcell¹,

Fergie²,

Peterson³

2006

Pediatric Infectious Disease Journal

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Cellulitis and abscess accounted for increasing percentages of inpatient (4.6-11.1%), outpatient (0.6-1.2%) and total (1.7-3.3%) expenses from 2001 through 2004. The per member per month expenses attributed to cellulitis and abscess increased from $0.74 in 2001 to $1.19 in 2004. The epidemic of community-acquired methicillin-resistant Staphylococcus aureus infections in children has had a significant economic impact on the Driscoll Children's Health Plan.

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“…The short tau inversion recovery sequence (STIR) was found to be more effective than the T1 contrast-enhanced sequence, particularly in delineating all findings of the SI joint inflammation and allowing for the early detection of septic sacroiliitis [2].…”

Section: Discussionmentioning

confidence: 99%

“…Pyogenic sacro-iliac joint (SIJ) infection is a rarely diagnosed musculo-skeletal infection; it accounts for 1-2% of septic arthritis and osteomyelitis [1][2][3]. Symptoms and signs are commonly non-specific with a vague clinical picture and poorly defined localization of symptoms.…”

Section: Introductionmentioning

confidence: 99%

Drainage of Pyogenic Sacro-Iliac Joint Infection Using a Percutaneous Technique (Case Series of 13 Patients)

Elbadrawi¹,

Morsi²,

Elkhateeb³

2017

MOJOR

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Purpose:Pyogenic sacro-iliac joint (SIJ) infection is a rarely diagnosed musculoskeletal infection. Symptoms and signs are commonly non-specific with a vague clinical picture and poorly defined localization of symptoms. This usually results in low clinical suspicion. This fact causes diagnosis to be difficult and delayed for several weeks or months.Methods:This study included 13 patients with the confirmed diagnosis of SIJ pyogenic infection who needed drainage after failure to respond to conservative treatment. The study was carried out between February 2012 and November 2015. Once suspected of having SIJ infection, patients where sent for radiographic and Laboratory tests. The drainage procedure was performed in the operative theatre using local infiltration anesthesia and under conscious sedation. Results:The mean age of patients was 32. The mean time interval from initial complaint till diagnosis was 12 weeks. C-reactive protein and ESR levels were at least double the normal in all 13 patients. Radiological changes in the form of SIJ destruction/sclerosis (x-ray, CT) were evident in 10 of the 13 patients. MRI evidence of SIJ infection was noted in all 13 patients.Mean improvement in VAS, ODI at end of treatment was 5.5, 64 respectively.Complications occurred in 4 patients and included, pelvic abscess formation, iliopsoas abscess formation, posterior subcutaneous abscess, septicemia, SIJ instability Conclusion: When conservative treatment fails or presentation is late with abscess formation and /or bone destruction, minimally invasive image guided drainage and irrigation can be very useful and will have minimal morbidity.

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STIR sequence in infectious sacroiliitis in three patients

Cited by 20 publications

References 7 publications

Infectious sacroiliitis: a retrospective, multicentre study of 39 adults

Infectious sacroiliitis: a retrospective, multicentre study of 39 adults

Economic Impact of the Community-Acquired Methicillin-Resistant Staphylococcus Aureus Epidemic on the Driscoll Children's Health Plan

Drainage of Pyogenic Sacro-Iliac Joint Infection Using a Percutaneous Technique (Case Series of 13 Patients)

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