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Sacroileitis

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SACROILEITIS - inflammation of the sacroiliac joint. The inflammatory process can spread to the synovial membrane (synovitis), affect the articular surfaces (osteoarthritis) or the entire joint (pan-arthritis). There are aseptic (infectious and allergic), specific (for example, with tuberculosis) and non-specific (purulent) sacroileitis.

Acute purulent sacroileitis begins with an increase in body temperature, chills. Severe intoxication develops rapidly, leukocytosis and an increase in ESR are detected in the blood. Locally, sharp pains are observed in the sacroiliac joint, aggravated by palpation, pressure on the wings of the ilium and overextension of the lower limb. The patient takes a forced position with bent legs. Radiologically, with purulent inflammation of the sacroiliac joint, affecting only the synovial membrane, there is an expansion of the joint gap and moderate osteoporosis of the joint parts of the sacrum and ilium. With osteoarthritis, the joint gap, on the contrary, is narrowed, the contours of the articular surfaces are uneven, blurred.

With a subacute course of purulent sacroiliitis, the onset of the disease is erased. Subfebrile body temperature, a mild increase in ESR, moderate local pain in the sacroiliac joint are noted. X-ray changes are sometimes detected after 2-3 weeks. Often the disease has a chronic course with frequent exacerbations.

A serious complication of purulent sacroiliitis is the formation of purulent sagging with a breakthrough into the gluteal region and especially into the pelvic cavity. In the presence of streaks palpation and rectal examination reveals a painful fluctuating elastic formation. Penetration of pus into the sacral openings and the spinal canal is accompanied by damage to the spinal cord and its membranes.

Patients with purulent sacroiliitis need hospitalization. Treatment is aimed at eliminating purulent inflammation and increasing the body's resistance. With purulent osteoarthritis, panarthritis, as well as in chronic forms of purulent sacroiliitis, surgical treatment is indicated.