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At least 991 records · Page 55Linked to original sources
PubMed2002

Clinics in diagnostic imaging (70). Bilateral sacroiliitis due to ankylosing spondylitis.

A 15-year-old boy was incidentally found to have bilateral sacroiliitis. Radiographs showed erosions and subchondral sclerosis of both sacroiliac joints. His ESR was raised and HLA-B27 was positive. Presumptive diagnosis was ankylosing spondylitis. The clinical and imaging features, including the radiographical classification, of sacroiliitis are discussed. Knowledge of the patterns of distribution and correlation with clinical manifestations aid in differentiating among the various causes of sacroiliitis.

Adolescent↗
PubMed1998

[Septic arthritis caused by S. pneumoniae. Report of 2 cases with unusual location].

Arthritis by S. pneumoniae, although no frequent, is a well-known disease in patients with underlying diseases and in which they complaint previous articular disease. In the present article 2 cases of location in shoulder and sacroiliac joints are described respectively in a woman with multiple myeloma and an esplenectomizaded man, associations nondescribed previously in literature. The importance of its suspicion in patients with factors of risk for sepsis by S. pneumoniae is emphasized.

Adult↗
PubMed1993

The iliac buttress. A computed tomographic study of sacral anatomy.

Fifty randomly selected computed tomographic (CT) scans of the lumbosacral spine (25 males and 25 females) were studied to determine: 1) if the lateral sacral masses could safely accept a 7 mm diameter rod (i.e., intrasacral rod insertion) and 2) what percentage of patients, both males and females, demonstrated coverage of the posterolateral sacrum by the ilia (i.e., iliac buttressing). In all patients the lateral masses (i.e., the lateral intrasacral mass measurements) appeared wide enough on CT to allow for safe insertion of a 7 mm diameter rod, or other similar size implant, down to at least the level of S2. The smallest distance measured for the width between the posteromedial margin of the sacroiliac joint and the lateral cortex of the S1 neuroforamen (i.e., the lateral intrasacral mass measurement) at its location approximately midway (anteroposterior) through the sacrum on CT cuts was 17 mm (mean 28 mm). This would appear to give adequate room for a 7 mm diameter rod to be inserted at this level in the lateral sacrum (i.e., intrasacral rod insertion). Forty-six patients (24 males, 96%; and 22 females, 88%) appeared to have sufficient CT coverage of the sacrum to conceptually provide for so called "sacroiliac buttressing" of rods, if rods or other implants were to be inserted distally into the lateral masses. After a review of the sacral anatomy by CT it appears that: 1) insertion of rods into the lateral sacral masses (i.e. intrasacral rod insertions), or intrasacral fixation with other similar size implants, would be possible and apparently safe; and 2) the ilia along with the sacroiliac interosseous ligaments sufficiently surround the back and sides of the posterolateral sacrum in most patients (92%), at least by CT assessment, to conceptually offer an indirect "buttress" for implants so inserted. Theoretically, this could biomechanically help resist the flexural loads across the lumbosacral level and possibly provide a method for improved sacral fixation with spinal instrumentation in certain patients.

Adult↗
PubMed1997

[Septic sacroiliac arthritis in an adolescent].

BACKGROUND: Septic sacroiliitis is often difficult to diagnose because the clinical findings can be misleading and the radiological signs delayed. CASE REPORT: A 16-year-old adolescent was hospitalized with a history of fever and painful hip. The initial hypothesis of hip osteoarthritis was not confirmed by ultrasonography or CT-scan. The bone scan was also normal. The definitive diagnosis of sacroiliitis was made 1 week later based on the clinical evolution and a positive blood culture. It was confirmed by a second bone scan and MR imaging. CONCLUSION: Examination of the sacroiliac joint needs several different tests. Although the initial bone scan may be normal, an osteoarticular infection cannot be definitively ruled out and iterative radiological investigation is warranted. MR imaging may be an additional diagnostic tool for detecting sacroiliitis.

Adolescent↗
PubMedDate not supplied

[Value of scintigraphy for the early diagnosis of spondylitis ankylosans].

Quantitative sacroiliac scintigraphy was performed in 33 patients with ankylosing spondylitis (AS), 34 patients with nonspecific low back pain, and 30 control subjects. Significantly increased uptakes over the sacroiliac joints (SIJ) were found in patients with AS and in patients with degenerative changes of the SIJ. No significant differences were found between patients with mechanical low back pain by lumbar strain or by degenerative changes of the lumbar spine and the control subjects. But there were 2 of 13 patients with low back pain by lumbar strain with pathologic uptakes over the ISG. Since the scintigraphic technique is not specific, it is necessary to compare the scintigraphic results with clinical and radiological findings in each patient. On this condition sacroiliac scintigraphy is useful in early diagnosis of AS.

Adult↗
PubMed1984

Laminectomy: effects on postoperative technetium and gallium scintigraphy.

Bone scans using Tc-99m diphosphonate were found to become abnormal within 2 weeks after laminectomy in less than half of patients regardless of the extent of the operation. The degree of new uptake equaled that of the sacroiliac joints in only one of 19 patients with a normal preoperative scan. However, the Ga-67 citrate scan usually became abnormal (89%) postoperatively. Thus the Tc-99m bone scan may be helpful in detecting postoperative infection.

Diphosphonates↗
PubMed1987

Use of force platform variables to quantify the effects of chiropractic manipulation on gait symmetry.

The purpose of this investigation was to determine whether force platform measurements can be used to objectively assess short-term effects of spinal manipulation on patients with diagnosed, chronic unilateral "sacroiliac dyskinesia," here defined as decreased interarticular mobility of the sacroiliac joint. Nine patients walked across a force platform, were than manipulated by a chiropractor and then repeated the gait trials. Temporal and kinetic gait variables from the force platform measurements were analyzed for changes in the symmetry of the subjects' gait before and after treatment sessions. There was a distinct tendency towards improved gait symmetry after treatment in those cases where the gait was asymmetric prior to the treatment. This result indicated that force platform measurements may be used successfully to assess the effects of spinal manipulations on the gait of patients with sacroiliac dyskinesia.

Adult↗
PubMed1984

Hyperostosis of the clavicle and ossification of the costoclavicular ligament in association with ankylosing spondylitis.

A patient with ossification of the ligaments of the entire vertebral column has shoulder difficulties due to ossification of the right costoclavicular ligament. The speculation is that the sclerotic changes in the clavicle were caused by the same inflammatory process that has involved the ligaments of the vertebral column and of the sacroiliac joints. In some cases reported in the literature, although not in ours, vascular structures in the costoclavicular space were involved, resulting in venous obstruction or phlebitis. The patient's therapy currently consists of rehabilitation exercises. Nonsteroidal antiinflammatory medication was prescribed in the past without any marked benefit.

Aged↗
PubMed1977

Psoriatic spondylitis: a clinical, radiological, and scintiscan survey.

Thirty-three per cent of patients with psoriatic spondyloarthropathy referred to a rheumatic disease unit were found to have radiological sacroiliitis. The majority of these patients had definite or probable spondylitis according to the New York criteria. Abnormal sacroiliac uptake of 99mTcPP on bone scan correlated well with the radiological finding of sacroiliitis. In addtion, eight patients with normal radiographs had an abnormal uptake of radionuclide over the sacroiliac joints, indicating sacroiliitis. Patients with sacroiliitis tended to have more severe psoriasis. Sacroiliitis occurred in association with all of the patterns of peripheral joint involvement which may occur in psoriatic arthritis. Although the HLA antigen B27 was present in only 21 percent of the total group and in 33 percent of those with sacroiliitis, 8 out of 10 with this antigen had sacroiliitis.

Adult↗
PubMed1982

The transitional lumbosacral osseous complex.

The weight of the head and trunk is transferred to the lower extremities through that segment of the spine articulating either directly or indirectly with the ilii. When a lumbosacral transitional vertebra is present the position of the weight-bearing platform usually changes. A bony entity is formed delineated superiorly by the top of the transitional vertebra and inferiorly by the lower level of the sacroiliac joints. This segment is designated as the transitional lumbosacral osseous complex. Measurements of its length in the three phylogenetic categories in man, including measurements of the articulating portion of the sacrum in the human mode, showed a range of 68 mm to 157 mm and variations from 2.0 to 3.7 in vertebral lengths.

Biomechanical Phenomena↗
PubMed1982

Traumatic presacral hemorrhage: angiographic diagnosis and therapy.

Presacral hemorrhage commonly accompanies fractures of the posterior pelvic ring. The source of this bleeding is the fractured cancellous bone and supporting ligamentous structures of the sacrum and sacroiliac joint. The radiologic appearance is of granular and punctate contrast accumulations due to extravasation from the iliolumbar and lateral sacral branches of the hypogastric artery. This bleeding can be controlled by small particle embolotherapy provided care is taken not to bypass the posterior division of the hypogastric artery.

Angiography↗
PubMed1982

Ureteral entrapment injury in blunt pelvic trauma: a case report.

An unusual ureteral injury occurred during blunt pelvic trauma in a 6-year-old boy. Crush injury opened the sacroiliac joint, and the ureter was trapped and obstructed during realignment of the joint. Combined retrograde and anterograde pyelography accurately localized the injury and surgical repair restored renal function, despite total ureteral obstruction lasting more than 3 months. The mechanism, diagnosis and treatment of this injury are discussed. Vascular and ureteral injuries must be ruled out carefully when treating blunt renal injuries conservatively.

Child↗
PubMed2001

Septic sacroiliitis: the overlooked diagnosis.

Infection of the sacroiliac joint is extraordinarily rare. However, the initial symptoms and signs associated with this condition are mundane, thus leading to delay in diagnosis, or even misdiagnosis. I report an extremely unusual pyogenic sacroiliitis caused by Salmonella and discuss key clinical components and protocol for the successful evaluation, diagnosis, and treatment of this uncommon illness.

Adolescent↗
PubMed1997

Acute gouty sacroiliitis: a case report and review of the literature.

A 45-year-old black woman with an acute attack of severe unilateral sacroiliitis, negative microbiologic studies, is presented. An open biopsy specimen of the sacroiliac joint revealed evidence of tophaceous gout. The unique features of the case, differential diagnosis, and pertinent literature on gouty sacroiliitis are reviewed. Acute gouty sacroiliitis, although it is rare, does occur and should be included in the differential diagnosis of unilateral sacroiliitis in patients with a long-standing history of gout.

Acute Disease↗
PubMed1993

Atypical salmonellosis: two cases of sacroiliitis.

Two young adult males presented with fever, severe pain, redness, swelling over the left sacroiliac joint and inability to walk and squat. A differential diagnosis of tuberculous sacroiliitis was considered. On blood culture isolation of S. Typhi in both of them was suggestive of sacroiliitis of salmonella etiology. They recovered completely following specific antibiotic therapy, aspirin and bed rest. At recovery both showed extremely high Widal titres.

Adolescent↗
PubMed2003

The diagnostic contribution of the frontal lumbar spine radiograph in community referred low back pain--a prospective study of 1030 patients.

AIM: The diagnostic contribution of the anteroposterior (AP) view was studied to assess whether this view could be omitted safely, thus reducing the radiation burden received by patients undergoing lumbar spine radiography. MATERIALS AND METHODS: Prospective analysis of 1030 consecutive referrals for lumbar spine radiography from general practice. RESULTS: In the majority of cases (90.5%) the AP view was non-contributory. In 4.2% the diagnosis was strengthened and it was altered in 4.6%. However, in the latter group only 1.3% of the total were considered significant alterations. These were cases of possible, but not definite, pars defects and sacroiliitis. Specific important conditions such as infection, malignancy and benign tumours were not missed on the lateral view alone, in our study population. The radiation burden is reduced by 75% by omitting the AP view. CONCLUSION: A single lateral view is an adequate examination, with the proviso that sacroiliac joint disease is not assessed on this view and some pars defects and facet joint degenerative changes may be overlooked. The radiation protection gains are considerable. A single lateral lumbar view is now our routine practice unless sacroiliitis is a specific clinical concern.

Adolescent↗
PubMed1984

Iliacus abscess.

Iliacus muscle abscess originating from the sacroiliac joint was diagnosed prior to operation in a 13-year-old boy with the assistance of technetium-99m bone imaging and computerized tomography. Preoperative identification of the iliacus abscess enabled the surgeon to select an anterior (apophyseal splitting) retroperitoneal approach, which permitted drainage of both the ilium and the iliacus muscle.

Abscess↗