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Clinical Medical
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ISSN: 2474-3682
IMAGE ARTICLE | VOLUME 3, ISSUE 3 | OPEN ACCESS DOI: 10.23937/2474-3682/1510071

Pyogenic Sacroiliitis and Multilocular Abscess Involving the Sacroiliac Joints in a Patient with Lumbar Pain

Ibrahim Guler1, Emine Uysal2, Nazlım Aktug Demir3, Hakan Cebeci1 and Mustafa Koplay1

1Department of Radiology, Medical Faculty, Selcuk University, Konya, Turkey

2Gurses Diagnosis Treatment and Health Services Inc., Konya, Turkey

3Department of Infectious Disease, Medical Faculty, Selcuk University, Konya, Turkey

*Corresponding author: Mustafa Koplay, M.D, Department of Radiology, Medical Faculty, Selcuk University, The Central Campus, 42075, Konya, Turkey, Tel: +90-332-2243800-44939, E-mail: koplaymustafa@hotmail.com

Received: June 16, 2017 | Accepted: September 04, 2017 | Published: September 06, 2017

Citation: Guler I, Uysal E, Demir NA, Cebeci H, Koplay M (2017) Pyogenic Sacroiliitis and Multilocular Abscess Involving the Sacroiliac Joints in a Patient with Lumbar Pain. Clin Med Img Lib 3:071. doi.org/10.23937/2474-3682/1510071

Copyright: © 2017 Guler I, et al. This is an open-access content distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

A 21-year-old female patient applied to our hospital with gluteal and lumbar pain. Physical examination revealed tenderness in the bilateral sacral-lumbar area and limitation of the bilateral hip joint. Sacroiliac joint MRI showed the bone marrow oedema, overlying soft tissue swelling, right gluteal muscles abscess and multilocular abscess involving the bilateral sacroiliac joint (Figure 1). Pyogenic sacroiliitis of sacroiliac joint is seen rarely, representing 1-2% of all cases of septic arthritis [1]. The most frequent symptom is lumbogluteal pain and the diagnosis is difficult because of the lack of symptom specifity. Staphylococcus aureus is the most detected organism in cases of pyogenic sacroiliitis [1,2]. In our case, the abscess was drained with percutaneous surgical approach and the patient responded well to antibiotic therapy.

Source of Support


None.

Conflicting Interest


None.

Disclosure of Interest


The authors declare that they have no any conflict of interest.

Figures


 


Figure 1: Coronal T1 weighted image (a), coronal (b) and axial (c) T2 weighted images, contrast enhanced coronal T1 (d) and fat saturation axial (e,f) T1 weighted images show the bone marrow oedema in right sacroiliac joint (star), overlying soft tissue swelling, right gluteal muscles abscess (arrowheads) and multilocular abscess involving the bilateral sacroiliac joint (arrows). Contrast enhancement was seen in bone marrow eodema regions compatible with sacroilitis (star). Fluid collections competible with multilocular abscess was showed peripheral enhancement (arrows).

References


  1. Kim S, Lee KL, Baek HL, Jang SJ, Moon SM, et al. (2013) A case of acute pyogenic sacroiliitis and bacteremia caused by community-acquired methicillin-resistant staphylococcus aureus. Infect Chemother 45: 441-445.

  2. Hermet M, Minichiello E, Flipo RM, Dubost JJ, Allanore Y, et al. (2012) Infectious sacroiliitis: A retrospective, multicentre study of 39 adults. BMC Infect Dis 12: 305.