Abstract
Pyogenic sacroiliitis is relatively rare in childhood. We report two cases: Case 1, a girl aged 12 years 6 months, who visited our hospital with a high fever (40.3°C) and right coxalgia. Case 2, a girl aged 11 years 7 months, presenting with a fever (39°C) and left buttock pain. Although no abnormalities were observed in the initial radiographs in either case, magnetic resonance imaging (MRI) indicated changes in the sacroiliac joint. Subsequent bone scintigraphy was valuable in localizing the sites. Laboratory examinations showed CRP levels of 6.4 mg/dl and 13.6mg/dl respectively. Blood-cultures indicated Staphylococcus aureus in both cases. After treatment with intravenous antibiotic, and about two or three weeks rest, the patients were able to walk unaided, without pain, and there has been no recurrence of infection.
Because clinical findings in pyogenic sacroiliitis may generally resemble a herniated intervertebral disc, septic spondylitis, or coxatitis, diagnosis is generally difficult in early stages. However, MRI and bone scintigraphy proved very useful.
