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Early Diagnosis of Septic Sacroiliitis in Children With MRI

Stapholococcus (staph) infection of the sacroiliac joint can cause septic sacroiliitis. The condition can affect children but is rare. Symptoms are nonspecific with frequent reports of back, buttock, or hip pain that can't be pinpointed.

In this study, surgeons from Japan report ways to diagnose this problem sooner than later. Delays in treatment can result in a worse outcome. X-rays do not show changes that would direct the physician to consider septic sacroiliitis. MRIs may be needed to make an accurate diagnosis.

Eight cases of septic sacroiliitis in children ages four to fifteen were included in the study. All eight patients had pain on one side that was misdiagnosed as a lumbar disc herniation. In some cases, the pain was reported in the knee, back, or buttock. In one patient, the painful symptoms presented in the abdomen.

MRIs can be used to assess the progress of treatment. But as these researchers found out, abnormal findings persisted on MRI even when the patients felt back to normal. Doctors are advised to remember that clinical improvement will be seen with this problem before the MRI shows resolution of the problem. Abnormal bone marrow changes were reported in this study for two to three months after treatment with antibiotics.

References: Akifusa Wada, MD, PhD, et al. Septic Sacroiliitis in Children. In Journal of Pediatric Orthopaedics. June 2008. Vol. 28. No. 4. Pp. 488-492.

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