A Case of Tuberculous Sacro-iliitis

AN INTERESTING CASE OF BACKPAIN Prof.K.H.Noorul Ameen’s Unit Dr.E.Thirulogachandar

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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],History of presenting illness

Past history ,[object Object],[object Object],[object Object]

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Investigations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

X-RAY AP VIEW OF BOTH SACROILIAC JOINTS

Immunological profile ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Seronegative spondyloarthropathies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Ankylosing spondylitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Ankylosing spondylitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Ankylosing spondylitis ,[object Object],Sacroiliac joints Grade 0 Normal Grade 1 Suspicious changes Grade 2 Minimal abnormality – small localized areas with erosion or sclerosis without alterations in joint width Grade 3 Unequivocal abnormality – moderate or advanced sacroiliitis with  1 of the following: erosions, sclerosis, widening, narrowing, or partial ankylosis Grade 4 Severe abnormality – total ankylosis

Reiter’s syndrome and Reactive arthritis (ReA) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Reactive arthritis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Reactive arthritis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Enteropathic Arthritis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CONTRAST OF SPONDYLOARTHROPATHY Feature Ankylosing Spondylitis Enteropathic Arthritis Psoriatic Arthritis Reactive Arthritis Male-female ratio 3:1 1:1 1:1 10:1 HLA association B27 B27(axial) B27(axial) B27 Joint pattern Axial Axial and peripheral Axial and asymmetrical peripheral Axial and asymmetrical peripheral Sacroiliac Symmetrical Symmetrical Asymmetrical Asymmetrical Syndesmophyte Smooth, marginal Smooth, marginal Coarse, nonmarginal Coarse, nonmarginal Eye Iritis +/- 0 Iritis and conjunctivitis Skin 0 0 Psoriasis Keratoderma Rheumatoid factor 0 0 0 0

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Freire M , Graña J , Míguez E , Pombo F , Atanes A , de Toro J , García Porrua C , Galdo B . An Med Interna. 1995 May;12(5):255-6 Sacroilitis as initial manifestation of miliary tuberculosis

Enferm Infecc Microbiol Clin. 1999 Feb;17(2):99-101. [Disseminated tuberculosis manifesting as a clinical picture of sacroiliitis] [Article in Spanish] Maestre JR , Quesada R , Fernández A .

A Case of Tuberculous Sacro-iliitis

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A Case of Tuberculous Sacro-iliitis