Abstract
Infections of the sacroiliac joint are uncommon and diagnosis is usually delayed. Bone and joint involvement in tuberculosis accounts for 1.8% of all tuberculosis cases (2006, Japan). Approximately 1% to 10% of skeletal tuberculosis occurs in the sacroiliac joint. We describe a 74-year-old woman with tuberculous sacroiliitis presenting with right buttock pain and difficulty in walking. MRI of the pelvis showed an increased STIR signal in the right sacroiliac joint suggestive of sacroiliitis possibly of infectious origin. Open biopsy, computed tomography of the chest and bone scintigraphy established the diagnosis of tuberculous sacroiliitis without tuberculosis at other sites including the lung. Treatment with four antitubercular drugs was initiated. Soon after the medication was started, the patient became pain-free and able to walk without canes. Sacroiliac joint infection must be included in the differential diagnosis of low back pain or buttock pain. For the treatment of tuberculosis, early diagnosis will promote a better prognosis.
