Visual Diagnosis in Emergency MedicineInfectious Sacroiliitis
Section snippets
Case Report
A 21-year-old previously healthy male presented to the emergency department with 7 days of left hip pain and inability to walk. There was no history of fever or trauma, no history of i.v. drug use, and the patient was feeling well 1 week ago. He awoke one morning with a minimal limp, although no pain. The following day he developed sharp left hip pain with radicular numbness. The patient was seen at another hospital and given steroids and pain medication without relief. The pain and limp
Discussion
ISI is a rare condition that often mimics common diagnoses, such as muscular strain and sciatica. The insidious onset and nonspecific signs and symptoms, such as lumbar gluteal pain and tenderness of the lower back, can lead to a delay in diagnosis, resulting in increased morbidity and long-term disability (1). Risk factors for ISI include trauma, pregnancy, i.v. drug use, endocarditis, and immunosuppression 1, 2. Laboratory values are nonspecific, with the most common abnormality being
References (4)
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Septic sacroiliitis: an uncommon septic arthritis
Clin Exp Rheumatol
(2009) - et al.
Infectious sacroiliitis: a retrospective, multicentre study of 39 adults
BMC Infect Dis
(2012)
Cited by (6)
Septic Sacroiliitis caused by Serratia marcescens
2020, American Journal of Emergency MedicineA Case Report of Infectious Sacroiliitis in an Adult Presenting to the Emergency Department with Inability to Walk
2017, Journal of Emergency MedicineCitation Excerpt :Prompt diagnosis can be difficult, as plain radiographs are frequently negative, and computed tomography is of limited value early in the disease. Suspicion of ISI warrants further evaluation with magnetic resonance imaging (6,7). Due to these diagnostic difficulties, the mean time to diagnosis is often quite long, with one study describing the mean time to diagnosis as 43.3 ± 69.1 days (2).
The contribution of SPECT/CT bone scintigraphy in the localization of an infective (Purulent) sacroiliitis – a case report
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