SAKROILITE - inflammation of the sacroiliac joint. The inflammatory process can spread to the synovial membrane (synovitis), affect articular surfaces (osteoarthritis) or the entire joint (pan-arthritis). Distinguish aseptic (infectious-allergic), specific (for example, with tuberculosis) and nonspecific (purulent) sakroileitis.
Acute purulent sakroileitis begins with an increase in body temperature, chills. Rapidly develops severe intoxication, in the blood there is leukocytosis , an increase in ESR. Locally there are sharp pains in the area of the sacroiliac joint, which are amplified by palpation, pressing on the wings of the ileal bones and re-flexing the lower limb. The patient takes a forced position with bent legs. Radiographically, with purulent inflammation of the sacroiliac joint affecting only the synovial membrane, there is an enlargement of the joint gap and a moderate osteoporosis of the articular parts of the sacrum and iliac bone. In osteoarthritis, the joint gap, on the contrary, is narrowed, the contours of articular surfaces are uneven, blurred.
With subacute flow of purulent sakroileitis, the onset of the disease is erased. Subfebrile body temperature, blurred increase in ESR, moderate local soreness in the sacroiliac joint area are noted. X-ray changes are detected sometimes after 2-3 weeks. Often, the disease has a chronic course with frequent exacerbations.
A severe complication of purulent sakroileitis is the formation of purulent swelling with a breakthrough in the gluteal region and especially in the pelvic cavity. In the presence of swollen palpation and rectal examination, a painful fluctuating elastic formation is revealed. The penetration of pus into the sacral orifices and the vertebral canal is accompanied by a lesion of the spinal cord and its membranes.
Patients with purulent sakroileitis need hospitalization. Treatment is aimed at eliminating purulent inflammation and increasing resistance of the body. With purulent osteoarthritis, panarthritis, as well as with chronic forms of purulent sakroileitis, surgical treatment is indicated.