Tuberculous sacroiliitis. Four cases.
Tuberculous sacroiliitis with no local abscesses or tuberculosis at other sites occurred in four patients, three men and one woman with a mean age of 42 years. Slow progression characterized this uncommon variant of joint tuberculosis. Two patients reported contact with family members known to have tuberculosis. Mean time from symptom onset to presentation was 14 months. Surgical biopsy showed epithelioid and giant-cell granulomas with caseous necrosis; culturing on Lowenstein-Jensen medium recovered the tubercle bacillus. Treatment was with antitubercular drugs, and protection from weight bearing for 4 weeks. These four cases illustrate the slowly progressive course of the clinical and radiological manifestations and underline the diagnostic difficulties met in the early stages of tuberculous sacroiliitis without tuberculosis at other sites. Antitubercular treatment can restore joint function provided the diagnosis is made before radiological destruction occurs.
Benchakroun
Mohammed
M
Trauma and Orthopedics Unit, Avicenne Teaching Hospital, 36, rue Robinia, Sector 24, G7, Hay Riad, Rabat 10100, Morocco. benchakrounmohammed@hotmail.com
El Bardouni
Ahmed
A
Zaddoug
Omar
O
Kharmaz
Mohammed
M
Lamrani
My Omar
MO
El Yaacoubi
Morad
M
Hermas
Mohammed
M
Wahbi
Saïd
S
Ouazzani
Najib
N
El Manouar
Mohammed
M
D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage*; D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009018:Morocco; D018570:Risk Assessment; D012446:Sacroiliac Joint / Q000473:pathology*; D012494:Sampling Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014374:Tuberculin Test; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis* / Q000188:drug therapy*
D000995:Antitubercular Agents