acute Pyogenic Sacroiliac Joint

        Male, 13 y/o, with left pelvic posterior pain and fever, 48 h duration. Ultrasound was normal. A 3 phase bone scan showed increased rim shape perfusion lateral to the left sacroiliac joint, with central cold area. The left sacroiliac joint had mild uptake diminution, compared to the contralateral joint (arrows). It was reported as consistent with infection in the sacroiliac joint and surrounding soft tissues. MRI, was concluded: Left infectious sacroiliitis, with involvement of joint space, bone tissue and adjacent muscle structures, showing some collections in the piriformis muscle. Staphylococcus aureus was found in blood culture. Patient was treated with cloxacillin 4 days followed by cephazoline for 3 weeks and clinical recovery.

References:

1      Palestro CJ, Love C. Radionuclide imaging of musculoskeletal infection: conventional agents. Semin Musculoskelet Radiol. 2007 Dec;11(4):335-52.

2        Taylor ZW, Ryan DD, Ross LA. Increased incidence of sacroiliac joint infection at a children's hospital. J Pediatr Orthop. 2010 Dec;30(8):893-8.

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