Radiological Followup of the Evolution of Inflammatory Process in Sacroiliac Joint with Magnetic Resonance Imaging: A Case with Pyogenic Sacroiliitis
Table 1
Clinical course of pyogenic sacroiliitis.
0 Mo
3 Mo
6 Mo
12 Mo
20 Mo
Clinic findings
(i) Fever
+
−
−
−
−
(ii) Night sweat
+
−
−
−
−
(iii) Right gluteal pain
Very severe
Moderate
Mild
No pain
No pain
(iv) Pain with sacroiliac stretch
Very severe
Mild
No pain
No pain
No pain
(v) Limitation of spinal mobility measurements
−
−
−
−
−
WBC, ×109/L
8.2
5.1
7.5
6.1
6.6
ESR, mm/h
65
4
5
5
5
CRP, mg/L
228
3,32
2.66
<3.4
<3.4
Rose Bengal
Positive
Positive
Negative
Not studied
Not studied
Wright agglutination
>1/320
1/160
<1/80
Not studied
Not studied
MRI findings
(i) Expansion of the sacroiliac joint space
++
++
+
−
−
(ii) Joint effusion of posteroinferior part of the joint
+
±
−
−
−
(iii) Bone marrow edema on the iliac and sacral surfaces
++++
+++
++
+
+
(iv) Sclerosis and irregularity
−
−
+
+
+
(v) Fatty bone marrow changes
−
−
+
+++
+++
(vi) Edematous changes on neighborhood muscles
+
+
−
−
−
Treatment
(i) NSAID use
Used
Used
On demand
On demand
Not used
(ii) Antibiotics
Used
Not used
Not used
Not used
Not used
The plus (+) and minus (−) signs were used instead of absent and present meaning. The severity of MRI findings are shown with plus sign. ++++ is defined as very high severity; +++ as high severity; ++ as moderate severity; and + as mild severity.
