Sacroiliitis - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Musculoskeletal System.

Sacroiliitis - an inflammation of the sacroiliac joint.The inflammatory process can extend to the synovium (synovitis), affect the articular surfaces (osteoarthritis) or the entire joint (panarthritis).There are aseptic (infectious-allergic), specific (for example, tuberculosis) and nonspecific (purulent) sacroiliitis.Aseptic sacroiliitis - see Arthritis, ankylosing spondylitis;.specific sacroiliitis - see Brucellosis, Tuberculosis extrapulmonary, bones and joints..

symptoms of sacroiliitis

Acute suppurative sacroiliitis begins with fever, chills.Acute suppurative sacroiliitis may occur when osteomyelitis, purulent focus breakthrough of bone or as a result of direct contact with the infection at an open injury.More often one-sided and is characterized by rapid flow with a high fever, pain in the abdomen on the affected side of the pelvis.During his often arise purulent streaks.

rapidly evolving severe intoxication, blood revealed leukocytosis, increased ESR.Locally there was a sharp pain in

the sacroiliac joint, worse on palpation, pressure on the iliac wings and hyperextension of the lower limb.The patient takes a forced situation with bent legs.Early diagnosis is difficult, if local clinical manifestations are mild.Children sacroiliitis is often regarded as an acute infectious disease.X-ray at a purulent inflammation of the sacroiliac joint, affecting only the synovium, marked expansion of joint space and moderate osteoporosis joint department of the sacrum and ilium.In osteoarthritis the joint space, on the contrary, is narrowed, the contours of the articular surfaces are uneven, blurred.

When subacute purulent sacroiliitis beginning erased disease.There have been low-grade body temperature, blurred increase in ESR, mild local pain in the sacroiliac joint.Physical activity decreases little patients.Radiographic changes are detected at times in 2-3 weeks.

often sacroiliitis has a chronic course with frequent exacerbations .Chronic sacroiliitis are more common acute and are mainly tuberculosis and brucellosis etiology.The last are often bilateral.Chronic sacroiliac disease is manifested by pain, pain similar to sciatica that make it difficult walking and prolonged standing.When a patient study noted pain in the sacroiliac joint in compression and tension of the pelvis of the wings, with a maximum flexion of femur and tibia on the affected side and the other leg straightened, by digital rectal study, with the pressure on the joint area.Tuberculous sacroiliitis sometimes gives wandering abscess on the back of the thigh.

diagnosis of chronic sacroiliitis made on the basis of clinical data and radiographic examination, to detect signs of lesions of the sacroiliac joint.X-ray picture is diverse: the partial or total destruction of the articular surfaces with the disappearance of joint space, osteoporosis lesions, multiple sclerosis, and destruction of the periarticular bone sections, sequesters a variety of sizes.When Brucella sacroiliitis helps diagnose seropositive for brucellosis.

Complications sacroiliitis

Severe complication of purulent sacroiliitis is the formation of purulent streaks with a break in the gluteal region, and especially in the pelvic cavity.In the presence of streaks, and palpation revealed a painful fluctuating elastic formation during rectal examination.The penetration of pus in the sacral spinal canal openings and accompanied by a lesion of the spinal cord and its membranes.

Treating sacroiliitis

patients with purulent sacroiliitis require hospitalization.Treatment is aimed at removing the purulent inflammation and increase resistance.When purulent osteoarthritis, panartritah, as well as chronic forms of purulent sacroiliitis shows resection of the sacroiliac joint with incision and drainage of purulent streaks, and if necessary, revision of the sacral canal and sacral holes outlook is usually favorable for life.

Treatment for acute sacroiliitis: antibiotics (penicillin, streptomycin and other IM.), With accumulation of pus - opening and drainage of purulent cavities.

Treatment of chronic sacroiliitis mostly conservative - specific antibiotic therapy (see Brucellosis, Tuberculosis of bones and joints.);tuberculous sacroiliitis - plaster immobilization crib, in some cases, surgical treatment with resection of the sacroiliac joint.

Aseptic sacroiliitis occurs chronically according to the type of osteoarthritis, and often accompanied by a variety of pelvic strain, lower extremities, spine, permanently occurs in ankylosing spondylitis.Treatment of aseptic sacroiliitis - elimination of the causes of disease and physiotherapy.