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骶髂关节结核再探讨——临床与放射学综述

Sacroiliac joint tuberculosis revisited - A clinico-radiological review.

作者信息

Jain Vijay Kumar, Iyengar Karthikeyan P, Botchu Rajesh, Vaishya Raju

机构信息

Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India.

Trauma and Orthopaedic Surgeon, Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK.

出版信息

J Clin Orthop Trauma. 2021 Nov 16;24:101707. doi: 10.1016/j.jcot.2021.101707. eCollection 2022 Jan.

Abstract

Osteoarticular Tuberculosis (TB) of the Sacroiliac (SI) joint is an uncommon site affected by infection. The SI joint is involved in approximately 5-10% of all cases of TB. Diagnosis of SI joint TB can be delayed in early stages due to its varied and hidden presentation and probability of being confused with other spinal diseases. Delay in diagnosis can lead to chronic pain, joint destruction, and a natural progression to symptomatic bony ankylosis. A focused clinical examination, complementary imaging, microbiological and histopathological confirmation of can direct a targeted therapy. Anti-Tubercular Therapy (ATT) regime remains a cornerstone in the overall management of SI joint TB. Early diagnosis allows conservative or non-operative management. Surgical interventions like abscess drainage, debridement, and arthrodesis with or without bone grafting may be required to achieve an excellent functional outcome.

摘要

骶髂关节骨关节炎性结核是一种较少见的感染部位。骶髂关节结核约占所有结核病病例的5-10%。由于骶髂关节结核的表现多样且隐匿,且有可能与其他脊柱疾病相混淆,其早期诊断可能会延迟。诊断延迟可导致慢性疼痛、关节破坏,并自然发展为有症状的骨性强直。有针对性的临床检查、辅助成像、微生物学和组织病理学确诊可指导靶向治疗。抗结核治疗方案仍然是骶髂关节结核整体管理的基石。早期诊断可采用保守或非手术治疗。可能需要进行手术干预,如脓肿引流、清创以及有无植骨的关节融合术,以获得良好的功能结果。

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