Sacroiliac Joint Tuberculosis

Sacroiliac TB is uncommon, ~8% of osteoarticular TB. Early symptoms and X-rays are nonspecific and easily misdiagnosed. As a local manifestation of systemic TB, it is receiving increasing attention. The joint is often severely destroyed with upward displacement of the ipsilateral sacrum and pathological dislocation, more common in women, sometimes with pubic symphysis dislocation, possibly related to the looser female pelvis.

Common Symptoms

Sacralization; bony destruction; neuralgia; sequestrum; night sweats; severe sacroiliac pain; low fever; sacroiliac joint pain

Causes and Pathogenesis

Bacilli infect the respiratory or digestive tract via contaminated air, then hematogenously seed bone. Sacroiliac TB is synovial or osseous. Pathogenesis: Severe destruction causes upward sacral displacement and pathological dislocation, more in women. Posteriorly, abscesses penetrate the posterior capsule or sacrum deep into the gluteus maximus; anteriorly, pus tracks between psoas and iliacus, within muscles, or under iliacus, occasionally to the groin or upper thigh; inferiorly, abscesses track along the sacrotuberous ligament or piriformis to the greater trochanter; they may interconnect and drain externally as sinuses; rarely, pus ruptures into the abdomen or rectum.

Treatment

Surgical treatment, drug therapy, supportive therapy, rehabilitation

Preventive Measures

Caused by tubercle bacilli and often a local manifestation of systemic TB; health education and active treatment of infected patients are key. TB can affect nearly any organ but is most common in the lung (>80%); other forms include pleurisy, meningitis, pericarditis, lymph node TB, endobronchial TB, intestinal/peritoneal TB, bone/joint TB, renal TB, and cutaneous TB. To prevent spread: control sources by finding and curing infectious pulmonary TB; protect susceptibles via neonatal BCG, screening close contacts, and preventive therapy for high-risk groups; practice good hygiene (no spitting, ventilation, exercise).

Department to Visit

It is recommended to visit the Orthopedic Surgery department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.