title: A Case Report of Infectious Sacroiliitis in an Adult Presenting to the Emergency Department with Inability to Walk.
abstract: BACKGROUND
  Infectious sacroiliitis (ISI) is an uncommon cause of back and hip pain in which the sacroiliac joint, either unilateral or bilateral, is inflamed from an infectious source. Historically, this has been an easily missed diagnosis due to nonspecific presenting symptoms along with subtle nondistinguishable laboratory abnormalities.
  
  
  METHODS
  We describe an injection drug user presenting with right-sided ISI who presented with hip and back pain and inability to walk. The patient had tenderness over his right sacroiliac joint, and despite negative plain radiographs, a magnetic resonance imaging (MRI) scan was obtained from the Emergency Department (ED) given the patient's risk factors for infection. Concerning findings of ISI on this MRI led to a computed tomography-guided biopsy during the patient's hospital admission, which revealed alpha-hemolytic Streptococcus as the responsible pathogen. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Infectious sacroiliitis is a rare condition that is difficult to diagnose, and carries increasing morbidity when diagnosis is delayed. We aim to increase awareness through a case report of a patient encountered in the ED.
authors.affiliation: Department of Emergency Medicine, Wake Forest Baptist Medical Center, Winston Salem, North Carolina.
authors.forename: Douglas
authors.initials: D
authors.lastname: Brtalik
authors.affiliation: Department of Emergency Medicine, Wake Forest Baptist Medical Center, Winston Salem, North Carolina.
authors.forename: Manoj
authors.initials: M
authors.lastname: Pariyadath
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000150:complications* / Q000175:diagnosis* / Q000209:etiology; D002443:Ceftriaxone / Q000494:pharmacology / Q000627:therapeutic use; D004636:Emergency Service, Hospital / Q000458:organization & administration; D006556:Heroin Dependence / Q000150:complications / Q000523:psychology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D051346:Mobility Limitation; D058566:Sacroiliitis / Q000175:diagnosis / Q000209:etiology*; D015819:Substance Abuse, Intravenous / Q000150:complications; D014640:Vancomycin / Q000494:pharmacology / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D002443:Ceftriaxone
keywords: back pain; drug abuse; inability to walk; infectious sacroiliitis; sacroiliitis