Rheumatology Advance Access originally published online on September 26, 2007
Rheumatology 2007 46(11):1684-1687; doi:10.1093/rheumatology/kem201
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Pyogenic sacroiliitis—a comparison between paediatric and adult patients
1Department of Emergency Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, 2Department of Nursing, Chang Gung Institute of Technology, Taoyuan, 3Department of Rehabilitation and Physical Medicine, Taipei Veteran General Hospital, Taipei, 4Department of Emergency Medicine, National Taiwan University Hospital, Yun-Lin Branch, Douliu and 5Graduate Institute of Epidemiology, College of Public Health, National Taiwan University Hospital, Taipei, Taiwan.
Correspondence to: Dr C.-C. Lee, Department of Emergency Medicine, National Taiwan University Hospital, Yun-Lin Branch, No. 7, Chun-Shan South Road, Taipei 100, Taiwan. E-mail: chnchnglee{at}ha.mc.ntu.edu.tw
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Abstract |
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Background. Pyogenic sacroiliitis is a rare cause of hip pain and fever. We aim to report a series of 33 patients with pyogenic sacroiliitis and to investigate the differences among paediatric and adult cases.
Methods. Clinical and laboratory data of 33 cases who were admitted to the emergency department with a confirmed discharge diagnosis of pyogenic sacroiliitis between 1996 and 2005 were assessed. All patients were divided into paediatric and adult groups by the age of 15 yr. The features of pyogenic sacroiliitis and clinical outcome were compared among the two groups. Several factors were analysed including gender, age, clinical signs and symptoms, laboratory tests, radiological examinations and scintigraphy.
Results. Among the all included patients, females were attacked more frequently than males (3: 1). One-third of patients had concurrent infections, of which urinary tract infections were the most common (41.6%). Compared with adult patients, paediatric patients tend to have fewer comorbid immunocompromized conditions, fewer concurrent infections, more equality in gender distribution and more presentations of weight bearing difficulty. Staphylococcus aureus was the main blood culture isolate from paediatric patients (80%), but only accounted for half of those from adult patients. Group B streptococcus and Salmonella spp. were not uncommon in the adult patients. Scintigraphic bone scan has the highest sensitivity (93.3%) and remains the image modality of choice. When local abscess formation is suspected, computed tomography or magnetic resonance imaging may be the preferred method used for examination.
Conclusion. This case series should alert the physicians to the possibility of pyogenic sacroiliitis and the difference between paediatric and adult patients.
KEY WORDS: Pyogenic sacroiliitis, Scintigraphic bone scan, MRI, Infectious arthritis
Submitted 2 April 2007;
revised version accepted 18 June 2007.
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  E. McCausland and N. Liggett Comment on: Pyogenic sacroiliitis--a comparison between paediatric and adult patients Rheumatology, May 1, 2008; 47(5): 740 - 741. [Full Text] [PDF]
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