Abstract
Background: Pyogenic sacroiliitis occurs infrequently during the peripartum period.
Case: A case at our institution and a review of the literature were analyzed. A total of 15 cases were discovered. The onset of illness was during pregnancy (40% of cases), within 3 weeks postpartum (40%) or post-abortion (20%), and the presentation was usually acute (< 7 days in 67% of cases). Frequent manifestations included localized pain in the hips or buttock, sacroiliac joint tenderness and fever. Computed tomography or magnetic resonance imaging revealed joint involvement in all cases tested. Microbiology was confirmed by blood (40%) or joint aspirate (75%), and most patients were treated with antibiotics. Surgical intervention took place in five cases. Pretermlabor was reported in only one case. All patients respondedwell to therapy without locomotive disability, and persistent pain was uncommon.
Conclusion: Septic sacroiliitis should be considered in peripartum patients who present with fever and severe localized pain. Medical management is usually curative, and without an adverse effect on pregnancy.
Full Text
The Full Text of this article is available as a PDF (100.1 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Egerman R. S., Mabie W. C., Eifrid M., Whitnack E., Sibai B. M. Sacroiliitis associated with pyelonephritis in pregnancy. Obstet Gynecol. 1995 May;85(5 Pt 2):834–835. doi: 10.1016/0029-7844(94)00311-z. [DOI] [PubMed] [Google Scholar]
- Gordon G., Kabins S. A. Pyogenic sacroiliitis. Am J Med. 1980 Jul;69(1):50–56. doi: 10.1016/0002-9343(80)90499-4. [DOI] [PubMed] [Google Scholar]
- L'episcopo J. B. SUPPURATIVE ARTHRITIS OF THE SACRO-ILIAC JOINT. Ann Surg. 1936 Aug;104(2):289–303. doi: 10.1097/00000658-193608000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Linnet K. M., Gammelgaard L., Johansen M., Krarup N., Rasmussen K. L. Bilateral pyogenic sacroiliitis following uncomplicated pregnancy and labor. Acta Obstet Gynecol Scand. 1996 Nov;75(10):950–951. doi: 10.3109/00016349609055034. [DOI] [PubMed] [Google Scholar]
- Sandrasegaran K., Saifuddin A., Coral A., Butt W. P. Magnetic resonance imaging of septic sacroiliitis. Skeletal Radiol. 1994 May;23(4):289–292. doi: 10.1007/BF02412363. [DOI] [PubMed] [Google Scholar]
- Siam A. R., Hammoudeh M., Uwaydah A. K. Pyogenic sacroiliitis in Qatar. Br J Rheumatol. 1993 Aug;32(8):699–701. doi: 10.1093/rheumatology/32.8.699. [DOI] [PubMed] [Google Scholar]
- Tisserant R., Loeuille D., Péré P., Gaucher A., Pourel J., Blum A. Septic sacroiliitis during the postpartal period. Diagnostic contribution of magnetic resonance imaging. Rev Rhum Engl Ed. 1999 Oct;66(10):512–515. [PubMed] [Google Scholar]
- Vyskocil J. J., McIlroy M. A., Brennan T. A., Wilson F. M. Pyogenic infection of the sacroiliac joint. Case reports and review of the literature. Medicine (Baltimore) 1991 May;70(3):188–197. doi: 10.1097/00005792-199105000-00003. [DOI] [PubMed] [Google Scholar]
- Wilbur A. C., Langer B. G., Spigos D. G. Diagnosis of sacroiliac joint infection in pregnancy by magnetic resonance imaging. Magn Reson Imaging. 1988 May-Jun;6(3):341–343. doi: 10.1016/0730-725x(88)90411-0. [DOI] [PubMed] [Google Scholar]
- Zimmermann B., 3rd, Mikolich D. J., Lally E. V. Septic sacroiliitis. Semin Arthritis Rheum. 1996 Dec;26(3):592–604. doi: 10.1016/s0049-0172(96)80010-2. [DOI] [PubMed] [Google Scholar]