Nutcharoen Aratara A, Salih Ahmed A, Volio Andrew, Skolaris Alexis, Ayad Sabry
Anesthesiology, Cleveland Clinic Fairview Hospital, Cleveland , USA.
Outcomes Research, Cleveland Clinic , Cleveland, USA.
Cureus. 2020 Jun 28;12(6):e8891. doi: 10.7759/cureus.8891.
Septic sacroiliitis is sacroiliac (SI) joint inflammation secondary to microbial invasion of the synovial space characterized by tenderness over the sacroiliac joint, difficulty walking, and lower back pain that can radiate to the buttocks. Clinicians can easily overlook septic sacroiliitis as a potential diagnosis due to its rare occurrence and non-specific symptoms. A 30-year-old female (G2P2A0) who presented acutely to the ED nine days after an uncomplicated Cesarean section performed under spinal anesthesia. The patient experienced progressive lancinating, electric-shock pain originating from the coccyx radiating to the right buttock and lower back with the inability to bear weight. MRI pelvis demonstrated edematous changes of the right SI joint, indicative of septic sacroiliitis. Patient's condition improved after empiric intravenous antibiotics and was discharged home on the continued intravenous course. Rapid empiric administration of intravenous antibiotics may have prevented the onset of severe complications of an infective SI joint.
化脓性骶髂关节炎是由于微生物侵入滑膜间隙继发的骶髂（SI）关节炎症，其特征为骶髂关节压痛、行走困难以及可放射至臀部的下背部疼痛。由于化脓性骶髂关节炎发病率低且症状不具特异性，临床医生很容易忽略将其作为一种潜在诊断。一名30岁女性（孕2产2，流产0次）在腰麻下行无并发症剖宫产术后九天急诊入院。患者自尾骨出现进行性刺痛、电击样疼痛，放射至右臀部和下背部，无法承重。骨盆磁共振成像显示右侧骶髂关节水肿改变，提示化脓性骶髂关节炎。经验性静脉使用抗生素后患者病情改善，并在持续静脉用药疗程中出院。快速经验性静脉使用抗生素可能预防了感染性骶髂关节严重并发症的发生。
