Background
Pediatric sacroiliitis is uncommon. The etiology may be infectious (Pyogenic Sacroiliitis) or inflammatory (e.g. post infectious, IBD, drugs). Treatment depends on the etiology. Sacroiliitis has a non-specific clinical presentation and laboratory findings. Diagnosis is usually confirmed using bone scintigraphy or MRI. Data on pediatric sacroiliitis is limited. The aim of this study is to describe the clinical features of pediatric patients with pyogenic sacroiliitis and to compare them to those of non–pyogenic sacroiliitis patients
Materials/methods
We retrospectively reviewed clinical files of children, aged 0-18 years, admitted with sacroiliitis between 2004 -2017. The collected data included: demographics, clinical presentation, imaging and laboratory findings, treatment protocols and outcome. The patients were divided into two groups according to etiology: pyogenic and non- pyogenic sacroiliitis.
Results
Study population included 40 patients (50% females) with pyogenic sacroiliitis and 17 patients (53% females) with non-pyogenic sacroiliitis. Compared to the non-pyogenic cases, pyogenic cases were significantly younger, 18.5 months (±14.4m) vs. 151.8 months (±54.4m) (p<0.001), had shorter duration of symptoms prior to hospital admission [. 5.8d (±7.4d) vs. 45.8d (±91.3d), p=0.007] and higher mean WBC at admission (14.62 k/ul (±5.2) vs. 11.75 k/ul (±4.7), p=0.06). No significant differences (p>0.2) were found in other indices including duration of hospital stay, CRP, and ESR. The pyogenic group was also characterized by uneventful medical history, fast response to antibiotics and better outcomes with less recurrences.
Conclusion
In this large cohort of pediatric patients with sacroiliitis, age
