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[不同类型感染性骶髂关节炎患者的临床及影像学特征]

[Clinical and imaging characteristics of patients with different types of infectious sacroiliitis].

作者信息

Ding Y X, He Y J, Lu J M, Su J B, Hu W L, Li T F, Liu S Y

机构信息

Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052,China.

出版信息

Zhonghua Nei Ke Za Zhi. 2021 Apr 1;60(4):368-372. doi: 10.3760/cma.j.cn112138-20200427-00427.

Abstract

To investigate the clinical manifestations and imaging characteristics of patients with different types of infectious sacroiliitis. Clinical data of 40 patients diagnosed with infectious sacroiliitis were retrospectively analyzed. Among the 40 patients, 16 patients were diagnosed as non-brucellar and non-tuberculous infectious sacroiliitis (ISI), 13 with tuberculous infectious sacroiliitis (TSI), and 11 with brucellar sacroiliitis (BSI). In the ISI and TSI group, female patients accounted for 11/16, 12/13, while the proportion of unilateral involvement was 15/16 and 12/13, respectively. Compared with ISI and TSI group, BSI patients were mainly male (8/11) and presented more bilateral involvement (6/11) (<0.05). Bone erosion was more common in ISI and TSI groups than in BSI group (6/15, 7/11 and 2/10), as well as abscess formation (3/15, 4/11 and 1/10, respectively). Symptoms in all patients relieved 1-2 weeks after administration of antibiotics or anti-tuberculosis treatment, but the resolution of the magnetic resonance imaging findings delayed about 6 (3-9) months. ISI and TSI patients with infectious sacroiliitis should be differentiated from spondyloarthritis, with a characteristic of more female patients, unilateral sacroiliitis, bone erosion, soft tissue involvement and abscess formation. However, BSI patients are mainly male, more bilateral involvement and less bone destruction and abscess formation. Antibiotic therapy demonstrates significant therapeutic effects, but resolution of the magnetic resonance imaging findings responses late.

摘要

探讨不同类型感染性骶髂关节炎患者的临床表现及影像学特征。回顾性分析40例确诊为感染性骶髂关节炎患者的临床资料。40例患者中,16例诊断为非布鲁菌性非结核性感染性骶髂关节炎(ISI),13例为结核性感染性骶髂关节炎(TSI),11例为布鲁菌性骶髂关节炎(BSI)。在ISI和TSI组中,女性患者分别占11/16、12/13,而单侧受累比例分别为15/16和12/13。与ISI和TSI组相比,BSI患者以男性为主(8/11),双侧受累更多见(6/11)(<0.05)。ISI和TSI组骨侵蚀比BSI组更常见(分别为6/15、7/11和2/10),脓肿形成情况也如此(分别为3/15、4/11和1/10)。所有患者在使用抗生素或抗结核治疗1 - 2周后症状缓解,但磁共振成像表现的消退延迟约6(3 - 9)个月。感染性骶髂关节炎的ISI和TSI患者应与脊柱关节炎相鉴别,其特点为女性患者更多、单侧骶髂关节炎、骨侵蚀、软组织受累及脓肿形成。然而,BSI患者以男性为主,双侧受累更多,骨破坏和脓肿形成较少。抗生素治疗显示出显著疗效,但磁共振成像表现的消退反应较晚。

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