Chronic sciatica caused by tuberculous sacroiliitis. A case report.
METHODS
This is a case report.


OBJECTIVE
To report and discuss a case of tuberculosis sacroiliitis with anterior synovial cyst presenting as chronic sciatica.


BACKGROUND
This is a report of clinical manifestation, physical findings, computed tomography scan, and results after surgical treatment in a 58-year-old woman with tuberculous sacroiliitis, which caused chronic sciatica.


METHODS
The physical findings, laboratory data, radiographs, and computed tomography scan of sacroiliac joints were studied. Sacroiliitis with anterior synovial cyst was shown in computed tomography scan. Posterior arthrotomy and drainage of the synovial cyst were performed. After surgery, she was treated with three combined antituberculosis drugs for 9 months.


RESULTS
Löwenstein-Jensen culture and histologic examination confirmed the diagnosis of tuberculous sacroiliitis. At 3 years, she had no back pain or sciatica and a complete functional recovery.


CONCLUSIONS
Tuberculous sacroiliitis with anterior synovial cyst is a rare cause of chronic sciatica. Lateral compression of the pelvis, Gaenslen's test, and Patrick's test should be included in evaluation of patients with sciatica. Computed tomography scan is a superb diagnostic method for sacroiliitis. Arthrotomy and drainage effectively relieve the sciatica. Three combined antituberculosis drug therapy should be given after surgery.
Chen
W S
WS
Department of Orthopedic Surgery, Chang-Gung Medical College, Kaohsiung, Taiwan.
D005260:Female; D006801:Humans; D008875:Middle Aged; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging*; D012585:Sciatica / Q000209:etiology*; D013581:Synovial Cyst / Q000150:complications / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014394:Tuberculosis, Osteoarticular / Q000150:complications* / Q000000981:diagnostic imaging