Stiffness in the lumbar region, pain in the buttock and sacrum, shooting in the thigh area, inflammation and redness of the tissues over the affected joint are signs of severe pathology. Sacroiliitis develops against the background of infectious, rheumatic diseases, as a result of trauma.

The appearance of discomfort, acute, paroxysmal pain in the lumbosacral zone is a signal for an urgent visit to a rheumatologist or vertebrologist. In the severe stage of the pathology, the patient feels serious discomfort, physical activity restriction is required: the disease significantly complicates life.

What is sacroiliitis

A characteristic symptom of the disease is inflammation in the sacroiliac joint of the spinal column. In the lower back, the patient feels pain, discomfort spreads to the thigh and buttocks. Sacroiliitis (ICD code - 10 - M46.1) acts as an independent pathology or is one of the symptoms of dangerous diseases: ankylosing spondylitis, brucellosis.

Causes

Inflammation in the lumbosacral zone develops against the background of the following factors:

• congenital anomalies in the development of vertebral structures;
• autoimmune pathologies;
• problems with mineral metabolism;
• trauma to the spine and pelvic region;
• excessive load on the sacroiliac joint for a long period;
• entry of infectious agents.

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First signs and symptoms

Negative manifestations largely depend on the degree of sacroiliitis and the type of pathology. The more active the inflammatory process, the more pronounced the signs of the disease. It is important to pay attention to the discomfort in the sacrum and lower back in time in order to prevent a severe stage of sacroiliitis.

Main symptoms:

• the main symptom is regular or paroxysmal pain in the lower back, radiating to the sacrum, buttocks, thigh;
• with bilateral sacroiliitis, discomfort appears when pressing any force on the sacrum. This sign is also fixed by doctors with pathological convergence of two iliac bones;
• unpleasant manifestations become stronger after staying in a static position, with long walking, after bending;
• the development of unilateral sacroiliitis is indicated by a characteristic detail - an involuntary transfer of weight to a healthy leg while climbing stairs (with a left-sided lesion - to the right limb, with a right-sided one - to the left);
• with phlegmon in the intermuscular space of the pelvis (diffuse inflammation against the background of suppuration), signs of general intoxication appear: fever, deterioration of health, fever, weakness, nausea.

Types and forms of the disease

Classification according to the area of ​​localization of the inflammatory process:

• osteoarthritis. Pathological changes develop on the articular surface;
• synovitis Inflammation affects the synovial membrane of the problem joint;
• panarthritis. The most severe form - the entire area of ​​​​the joint is affected.

Doctors distinguish three types of sacroiliitis:

• infectious-allergic or aseptic. Inflammation develops without the presence of infectious agents, against the background of autoimmune pathologies;
• non-infectious. Causes: degeneration of the joints against the background of a violation of mineral metabolism, as a result of an injury that provoked inflammation in the area of ​​the sacrum and lower back;
• specific. Sacroiliitis develops against the background of serious diseases (, brucellosis, syphilis) after the penetration of dangerous pathogens.

There is a classification of sacroiliitis according to a combination of other signs:

• arthralgia on the background of syphilis;
• left-sided purulent sacroiliitis as a result of the penetration of infectious agents into the wound after injury;
• synovitis or osteoarthritis with a long course on the background of brucellosis. Inflammation affects one and two sides of the pelvic area;
• acute and chronic form of pathology in tuberculosis. This type of inflammatory process in the lumbar and sacral area can be both unilateral and bilateral.

Stages of sacroiliitis:

• first. The symptoms are weak, sometimes patients feel a slight stiffness of the lumbar areas after sleep, and they are rarely bothered by pulling pains in the back. Physical activity provokes the activation of the inflammatory process. An important sign is that lumbar pains radiate to the area of ​​the Achilles tendon;
• second. At this stage, a bilateral lesion of the sacroiliac joint develops, patients note pain in the buttocks and thigh, paroxysmal cramps and. A curvature appears in the lumbar zone, stiffness of movements remains;
• third. If untreated, ankylosis of the ilium and sacral zone develops. Negative changes shows or and lower back. Against the background of compression of the nerve roots, blood pressure rises, painful muscle cramps occur, asthma attacks are possible, it develops.

Diagnostics

The causes of discomfort in the lower back, thigh, buttocks are clarified by a vertebrologist, rheumatologist or infectious disease specialist. Often a consultation of several doctors is required. It is necessary to draw up a complete clinical picture, conduct special tests to determine the type and stage of the disease.

If bilateral sacroiliitis is suspected, it should be determined whether Ferpson's symptom is present. The patient sits on a chair, lowers one leg down. At this moment, a sharp pain is felt in the lumbosacral zone. Also, discomfort increases if the patient takes the leg to the side. With a unilateral form of the disease, especially purulent, the development of phlegmon, the affected area turns red, swells, pain is felt on palpation.

The specialist must prescribe:

• x-ray of the lumbar and sacral area. The study shows a noticeable decrease in the size of the joint space, with a severe degree of the disease - a complete absence of the lumen. Radiography helps to identify purulent sacroiliitis and moderate;
• blood analysis. With an active inflammatory process, the level of leukocytes is increased by 2 or 3 times, with the second and third degree of pathology, the ESR index is significantly increased. With an infectious form of the disease, a blood test shows the presence of antibodies to a certain type of microorganisms.

On a note! It is important to identify the cause of the inflammatory process in the area of ​​the iliac-sacral joint. If pathogenic bacteria are found, then an antibiotic sensitivity test is required to identify the most powerful drug for a particular type of pathogen.

Effective Treatments

At an early stage of sacroiliitis, patients rarely start therapy due to untimely access to a vertebrologist against the background of mild negative symptoms. More often in the doctor's office there are people with complaints of severe pain in the lower back and sacrum. After the examination, the specialist reveals one- or two-sided sacroiliitis of 2-3 degrees. The presence in the body of dangerous infections, such as tuberculosis or syphilis, the accumulation of purulent masses in advanced cases of the disease complicates the course of the disease.

First, you need to cure the background pathology, smooth out the consequences of injuries. In parallel, the patient receives antibacterial compounds,. As the cause for the pathological process in the joint disappears, the inflammation subsides. During this period, the doctor adds exercise therapy, physiotherapy and therapeutic massage.

The main methods of therapy for sacroiliitis of the second or third degree:

• destruction of pathogens of syphilis, brucellosis, tuberculosis, and other infections. The patient takes a complex of drugs, including powerful antibiotics. The course of specific treatment - up to six months or more according to the scheme for each type of infectious pathology;
• with the traumatic nature of sacroiliitis, it is necessary to set the damaged joint, fix it for 10 days or more;
• with the development, girdle nature of pain, doctors combine anti-radiculitis and anti-neuralgic treatment methods;
• To reduce the intensity of pain, NSAIDs are prescribed. The compositions have a complex effect on the affected joint: they stop inflammation, reduce pain;
• with purulent sacroiliitis, antibiotics are required;
• joint damage against the background of psoriatic arthritis requires the appointment of monoclonal antibodies and cytostatics;
• if the lesion of the lumbosacral region occurs against the background of autoimmune diseases, then the doctor prescribes drugs to reduce the risk of exacerbations in lupus erythematosus and other pathologies. Therapy is carried out by a rheumatologist, treatment is only conservative;
• to quickly eliminate pain in a problem joint, the doctor prescribes electrophoresis with hydrocortisone, the electropuncture method. Procedures can be carried out with the non-infectious nature of the pathology or after suppressing the activity of dangerous pathogens;
• a useful procedure - rubbing bischofite and massage with the use of healing sea buckthorn oil;
• a good analgesic effect is given by ointments with analgesic action. With active inflammation, compositions with a warming effect are not used, after stopping the acute process, eliminating infectious agents, various types of gels and are allowed.

HB acute period, the patient should completely or partially reduce physical activity. In a serious condition, you need to lie more, sit and walk less often to reduce the load on the sacrum and lower back. If there is evidence, the doctor prescribes wearing an orthopedic. During the period of remission, simple physical exercises are useful. The basis of the exercise therapy complex for sacroiliitis is breathing exercises and stretching. Great options: aqua fitness, pilates and yoga.

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recovery prognosis

The duration and result of therapy depends on the type of disease, the degree of development of the pathological process. With the rheumatic nature of the pathology, therapy is long-term (for several years), periods of remission alternate with exacerbations. The autoimmune nature of the disease does not allow to quickly and completely eliminate the risk of inflammation of the sacroiliac joint.

Is the pathology infectious? With the timely start of complex therapy, the prognosis is favorable. The duration of the course depends on the type of underlying disease, for example, with tuberculosis, treatment lasts 6, 9, 12 months, a year, in severe cases - longer. An important nuance is the state of the immune system.

Prevention measures

• daily physical education;
• strengthening immunity;
• timely treatment of infectious pathologies so that pathogenic organisms do not penetrate the joints;
• reducing the risk of congestion during sedentary work: periodic warm-up, change of body position;
• refusal of overloads in case of pain in the joint;
• timely visit to the vertebrologist, discipline during treatment.

If you suspect sacroiliitis, pain in the iliac-sacral, gluteal, femoral region, you should contact a rheumatologist or vertebrologist in time to find out the cause of discomfort. Treatment of the underlying disease, elimination of the consequences of injuries reduces the likelihood of relapses, improves the condition of the problem joint.

Video - a fragment from the TV show "Life is great!" how to treat sacroiliitis:

Sacroiliitis is an extremely insidious and dangerous disease, which is characterized by inflammation of the sacroiliac joint. Pathology affects young people of working age. After 10-15 years, 70% of them experience severe irreversible changes in the joint. This leads to a significant decrease in the quality of life and loss of ability to work.

Due to similar clinical symptoms, sacroiliitis is often confused with degenerative-dystrophic diseases of the lumbosacral spine (osteochondrosis, spondylarthrosis, spondylosis, etc.). Most patients show radiological signs of these diseases. Most doctors stop there, make a diagnosis and send the patient for treatment. But ... sacroiliitis very often develops along with other diseases of the spine. It can have different causes and indicate the presence of other, more serious systemic diseases.

Judging by the comments on the forums, doctors have difficulty in diagnosing the disease and give patients vague diagnoses like “dorsalgia” or “vertebrogenic lumbalgia”. There are also frequent cases when doctors detect osteochondrosis in a patient, but do not find a concomitant lesion of the sacroiliac joint. All this is due to the lack of clear radiological signs of sacroiliitis in the early stages of the disease.

In the international classification of diseases (ICD-10), sacroiliitis is assigned the code M46.1. Pathology is referred to as inflammatory spondylopathies - diseases of the spine, which are accompanied by a progressive dysfunction of its joints and a pronounced pain syndrome. Sacroiliitis is listed in other headings as a symptom of certain diseases of the musculoskeletal system and connective tissue. An example is the involvement of the sacroiliac joint in osteomyelitis (M86.15, M86.25) or ankylosing spondylitis (M45.8).

In its development, sacroiliitis goes through several successive stages. Changes on radiographs appear only on the last of them, when it is extremely difficult to treat the pathology. Sacroiliitis can develop against the background of many diseases, which makes it difficult to diagnose and classify.

We will deal with the causes and classification of the disease.

Classification and description of types of sacroiliitis

Inflammation of the sacroiliac joint can be an independent disease or occur secondary to autoimmune or infectious diseases. Sacroiliitis can be unilateral or bilateral, acute, subacute, or chronic.

Single and double sided

In most cases, inflammation of the sacroiliac joint is unilateral. With the localization of the pathological process on the right, we are talking about right-sided, on the left - left-sided sacroiliitis.

2-sided sacroiliitis - what is it and why is it dangerous? The disease is characterized by simultaneous involvement in the inflammatory process of both sacroiliac joints at once. This pathology is often a sign of Bechterew's disease, which has a severe course and leads to early disability.

Degrees of activity of bilateral sacroiliitis:

• Level 1 is the minimum. A person is concerned about moderate pain and slight stiffness in the lower back in the morning. With concomitant damage to the intervertebral joints, there may be difficulties in flexion and extension of the lower back.
• Grade 2 - moderate. The patient complains of constant aching pain in the lumbosacral region. Stiffness and discomfort persist throughout the day. The disease prevents a person from leading a normal life.
• 3 degree - pronounced. The patient is tormented by severe pain and severe limitation of mobility in the back. In the region of the sacroiliac joints, ankylosis is formed in him - complete fusion of bones between themselves. The pathological process involves the spine and other joints.

At an early stage of the disease, radiological signs are either absent or almost invisible. Foci of osteosclerosis, narrowing of the interarticular spaces and signs of ankylosis appear only in grades 2 and 3 of sacroiliitis. It is possible to diagnose the disease at its very beginning with the help of MRI. Most patients with sacroiliitis go to the doctor only at stage 2 of the disease, when the pain begins to cause discomfort.

Infectious non-specific

Most often it develops as a result of infection with the blood stream in acute hematogenous osteomyelitis. Pathogenic microorganisms can also enter the joint from nearby foci of infection. The cause of the pathology are penetrating wounds and surgical interventions.

Typical symptoms of acute purulent sacroiliitis:

• severe pain in the sacrum, aggravated by movement;
• forced position of the patient - he takes the "fetal position";
• a sharp increase in temperature to 39-40 degrees;
• general weakness, chills, headaches and other signs of intoxication.

In the general blood test, the patient reveals an increase in ESR and leukocytosis. At first, there are no visible changes on the radiographs, later the expansion of the joint space becomes noticeable, caused by the accumulation of pus in the synovial cavity of the joint. In the future, the infection spreads to nearby organs and tissues. A patient with purulent sacroiliitis requires immediate surgical intervention and a course of antibiotic therapy.

tuberculous

The sacroiliac joint is one of the “favorite” places for Mycobacterium tuberculosis. According to statistics, sacroiliitis is detected in 40% of patients with the osteoarticular form of the disease. Women get sick 2 times more often than men. The inflammation has unilateral localization.

Signs of pathology:

• local pain, swelling and redness of the skin at the projection site of the iliac-sacral junction;
• pain in the buttocks, sacrum, back of the thigh, which increase with movement;
• scoliosis with a curvature to the healthy side, difficulties and a feeling of stiffness in the lower back caused by reflex muscle contraction;
• a constant increase in body temperature up to 39-40 degrees, signs of an inflammatory process in the general blood test.

X-ray signs of tuberculous sacroiliitis appear as the destruction of the bones that form the iliac-sacral joint. Initially, foci of destruction with sequesters appear on the ilium or sacrum. Over time, the pathological process spreads to the entire joint. Its contours become blurred, due to which there is a partial or even complete disappearance of the joint space.

Syphilitic

In rare cases, sacroiliitis can develop with secondary syphilis. It proceeds in the form of arthralgia - pain in the joints, quickly disappearing after adequate antibiotic therapy. More often, inflammation of the iliac-sacral joint occurs with tertiary syphilis. Such sacroiliitis usually proceeds in the form of synovitis or osteoarthritis.

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In the bone or cartilaginous structures of the joint, syphilitic gums can form - dense rounded formations. X-ray examination is informative only with significant destructive changes in the bones of the iliac-sacral joint.

brucellosis

In patients with brucellosis, sacroiliitis develops quite often. The iliosacral joint is affected in 42% of patients with arthralgias. The disease is characterized by periodic pain of a flying nature. One day, the shoulder may hurt, the second - the knee, the third - the lower back. Along with this, the patient has signs of damage to other organs: the heart, lungs, liver, organs of the genitourinary system.

Much less frequently, patients develop sacroiliitis in the form of arthritis, periarthritis, synovitis, or osteoarthritis. Both one and both joints can be involved in the pathological process. It is impossible to diagnose brucellosis sacroiliitis with the help of radiographs due to the absence of specific signs of pathology.

Psoriatic

Psoriatic sacroiliitis is detected in 50-60% of patients with psoriasis. Pathology has a clear x-ray picture and does not cause difficulties in diagnosis. The disease is asymptomatic and does not cause any discomfort to the person. Only 5% of people have a clinical and radiological picture resembling that of Bechterew's disease.

More than 70% of patients with psoriasis suffer from arthritis of different localization. They have a pronounced clinical course and lead to disruption of the normal functioning of the joints. Most often, oligoarthritis occurs in patients. Ankle, knee, hip or other large joints may suffer.

In 5-10% of people, polyarthritis of the small interphalangeal joints of the hand develops. The clinical course of the disease resembles rheumatoid arthritis.

Enteropathic

Inflammation of the iliosacral joint develops in about 50% of patients with chronic autoimmune bowel diseases. Sacroiliitis occurs in people with Crohn's disease and ulcerative colitis. In 90% of cases, the pathology is asymptomatic.

The severity of the inflammatory process and degenerative changes in the joint does not depend on the severity of the intestinal pathology. And the specific treatment of ulcerative colitis and Crohn's disease does not affect the course of sacroiliitis.

In 10% of cases, enteropathic sacroiliitis is an early symptom of ankylosing spondylitis. The clinical course of ankylosing spondylitis in intestinal pathology does not differ from that in the idiopathic (unspecified) nature of the disease.

Sacroitis in Reiter's syndrome

Reiter's syndrome is called a combined lesion of the organs of the genitourinary system, joints and eyes. The disease develops due to chlamydial infection. Less common pathogens are mycoplasmas and ureaplasmas. Also, the disease can develop after intestinal infections (enterocolitis, shigellosis, salmonellosis).

Classic signs of Reiter's syndrome:

• connection with a previous urogenital or intestinal infection;
• young age of patients;
• signs of inflammation of the urinary tract;
• inflammatory eye damage (iridocyclitis, conjunctivitis);
• the patient has an articular syndrome (mono-, oligo- or polyarthritis).

Sacroiliitis is detected in 30-50% of patients with Reiter's syndrome. Inflammation is usually reactive and unilateral in nature. Along with this, patients may also be affected by other joints, develop plantar fasciitis, subcalcaneal bursitis, periostitis of the vertebrae or pelvic bones.

Sacroiliitis in ankylosing spondylitis

Unlike purulent infectious, reactive, tuberculous and autoimmune sacroiliitis, it always has bilateral localization. In the initial stages, it is almost asymptomatic. Acute pain and impaired mobility of the spine occur in a later period due to the gradual destruction of the joints.

Ankylosing sacroiliitis is one of the symptoms of Bechterew's disease. In many patients, the intervertebral and peripheral joints are affected. Typically, the development of iridocyclitis or iritis - inflammation of the iris of the eyeball.

The role of CT and MRI in diagnosis

X-ray signs appear in the later stages of sacroiliitis, and not in all its types. X-ray diagnostics does not allow timely detection of the disease and timely start of treatment. However, it is possible to diagnose the disease at the initial stages of development using other, more modern research methods. Early signs of sacroiliitis are best seen on an MRI.

The presence of reliable radiographic signs of damage to the sacroiliac joint allows the diagnosis of sacroiliitis to be made. In the absence of clear changes on radiographs, patients are recommended to determine the status of HLA-B27 and use more sensitive imaging methods (CT, MRI).

Magnetic resonance imaging (MRI) is the most informative in the diagnosis of sacroiliitis at the earliest stages. It allows you to identify the first signs of the inflammatory process in the joint - fluid in the joint cavity and subchondral bone marrow edema. These changes are not visualized on computed tomography (CT) scans.

Computed tomography is more informative in the later stages of sacroiliitis. CT reveals bone defects, cracks, sclerotic changes, narrowing or expansion of the joint space. But computed tomography is practically useless in the early diagnosis of sacroiliitis.

How to treat: etiological approach

Having heard the diagnosis of "sacroiliitis" many people fall into a stupor. What is this disease, and what are its consequences? How to cure it and is it possible at all? What muscles are pinched in sacroiliitis and can they cause pinching of the sciatic nerve? What drugs to take, what exercises to do, how to dress in case of illness? Do they give disability in case of ankylosing spondylitis, which caused an irreversible dysfunction of the spine? These and many other questions haunt the majority of patients.

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The most important step in dealing with sacroiliitis is identifying its cause. To do this, a person needs to undergo a full examination and pass a series of tests. After that, the patient is prescribed etiological treatment. Patients with tuberculosis are shown a scheme of anti-tuberculosis therapy, people with infectious diseases are given antibiotic therapy. In autoimmune pathology, steroid hormones are used.

Basic Treatments

The tactics of treatment and prognosis for a disease depend on its cause, the activity of inflammation and the degree of involvement of articular structures in the pathological process. In the presence of symptoms of acute purulent sacroiliitis, the patient is shown immediate surgical intervention. In all other cases, the disease is treated conservatively. The question of the expediency of the operation arises in the later stages, when the disease is no longer amenable to conservative therapy.

Which doctor treats sacroiliitis? Orthopedists, traumatologists and rheumatologists are engaged in the diagnosis and treatment of pathology. If necessary, the patient may need the help of a phthisiatrician, infectious disease specialist, therapist, immunologist or other specialist.

To relieve pain in sacroiliitis, drugs from the NSAID group are used in the form of ointments, gels or tablets. For severe pain, non-steroidal anti-inflammatory drugs are administered intramuscularly. In case of pinching and inflammation of the sciatic nerve, the patient is given drug blockades. For this purpose, he is injected with corticosteroids and non-narcotic analgesics at a point as close as possible to the place where the nerve passes.

After the acute inflammatory process subsides, a person needs to undergo a course of rehabilitation. In this period, massage, swimming and therapeutic exercises (exercise therapy) are very useful. Special exercises help restore normal mobility of the spine and get rid of the feeling of stiffness in the lower back. You can use folk remedies for sacroiliitis with the permission of the attending physician.

Sacroiliitis is an inflammatory process in the sacroiliac joint. It can be an independent disease or a symptom of other diseases of an infectious or autoimmune nature. Usually sacroiliitis develops on one side. Bilateral sacroiliitis can be observed with brucellosis (less often with tuberculosis) and is a constant symptom in Bechterew's disease. The treatment plan and prognosis depends on the form and causes of sacroiliitis.
The sacroiliac joint is a sedentary articulation through which the pelvis is connected to the spine with the help of ear-shaped joints located on the lateral surfaces of the sacrum. The joint is held by the strongest ligaments of the human body - the interosseous sacro-lumbar ligaments, short wide bundles that are attached to the sacrum on one side and to the iliac tuberosity on the other.
The sacrum is the second section of the spine from the bottom (below it is the coccyx). In children, the sacral vertebrae are located separately from each other. Then, at the age of 18-25, these vertebrae fuse together, forming a single massive bone. With congenital malformations (back bifida), fusion may be incomplete.

Nonspecific (purulent) sacroiliitis.

sacroiliitis in tuberculosis.

sacroiliitis in syphilis.

Sacroiliitis in brucellosis.

Aseptic (infectious-allergic) sacroiliitis.

Sacroiliitis of non-infectious nature.

Find out what is the danger of sacroiliitis disease, its causes, main symptoms, stages of the disease, methods of treatment and prevention.

Sacroiliitis - what is this disease?

The sacroiliac joint is a tight paired joint that connects the sacrum and the largest of the pelvic ilium. The sacrum itself is five fused vertebrae that form a large bone. The ligamentous apparatus of the sacroiliac joint is the strongest in the human body.

In the international classification of diseases ICD-10, sacroiliitis, not classified elsewhere, was designated M46.1.

Classification of sacroiliitis

There are several types of classification of sacroiliitis: by area of ​​distribution, by the nature of the inflammatory process, by location and severity.

Depending on the area of ​​\u200b\u200bdistribution of inflammation of the sacroiliac joint, there are:

• synovitis. Inflammation of the inner layer of the articular bag;
• Osteoarthritis. Damage to the cartilaginous tissue of the articular surfaces;
• Panarthritis. The defeat of all anatomical formations of the joint.

• Purulent sacroiliitis. It can develop with trauma or have an infectious origin. Dangerous by the likelihood of purulent discharges entering the spinal canal and pelvic cavity, which can lead to serious consequences.
• Subacute sacroiliitis occurs with more severe symptoms than chronic but does not progress to the acute stage.
• Chronic sacroiliitis. It usually results from infections. It occurs more often than acute inflammation.

Symptoms

If you have one or more of the listed symptoms of sacroiliitis, then this is an occasion to consult a specialist. Diagnosis and treatment of inflammation of the sacroiliac joint are carried out by orthopedists and rheumatologists. With the traumatic nature of the inflammation, you should first make an appointment with a traumatologist.

The main symptom of sacroiliitis is pain in the lower back. It is the pain in the sacrum that causes an appeal to a specialist. In this case, the pain may be permanent or appear spontaneously; aggravated by movement or prolonged rest. It all depends on the nature of the disease and its intensity.

Another sign of inflammation of the sacroiliac joint is Ferguson's symptom: the patient, leaning, slowly stands on a chair or couch, first with one, then with the other foot; after that, it descends to the floor, starting with one foot. With sacroiliitis, discomfort occurs in the lower back and sacrum.

Patients with sacroiliitis also experience:

• Pain in the buttocks;
• Pain in the abdomen;
• gait disorder;
• Fever with accompanying chills.

Diagnostics

The main diagnostic measure for the detection of sacroiliitis is an x-ray examination of the sacroiliac joint. The most informative direct projection. Less often, additional local shooting is carried out with turns of the patient. At the same time, radiological signs of sacroiliitis in the initial stages of the disease are not pronounced, which often makes it difficult to make a diagnosis. When possible, MRI is used to diagnose sacroiliitis.

For more information, the following tests may be ordered:

• Erythrocyte sedimentation rate;
• For antibodies to own immunoglobulins of class G.;
• Antinuclear antibodies ELISA;
• Molecular genetic study of HLA-B27.

• Reimist. Painful sensations with pressure on the sacroiliac joint from behind.
• Baer. Painful sensations with pressure on the sacroiliac joint in front.
• Makarov. Painful sensations when tapping in the area of ​​the sacroiliac joints.
• Trendelenburg. Weakness of one or two gluteal muscles.
• Genslin. Pain in the area of ​​the sacroiliac joint with maximum flexion of the leg joints on the same side.
• Conform. Discomfort when trying to put one leg on top of the other in a sitting position.
• Kushelevsky. Pain when spreading or squeezing the wings of the iliac bones in the supine position.

Treatment

All activities, procedures and medications are prescribed by the attending physician. The information contained in the article is not intended for self-treatment! This can lead to a sharp deterioration in the condition and serious consequences.

The first thing to decide is which doctor treats sacroiliitis in your case. With a traumatic nature of origin, you need to contact a traumatologist. In other cases, an orthopedist or rheumatologist.

In most cases, sacroiliitis is a companion of the underlying disease. Therefore, therapeutic measures are aimed primarily at eliminating the root cause of inflammation and relieving its symptoms.

With the salmonella and brucellosis nature of the disease, the infection is suppressed by antibiotics. Traumatic sacroiliitis is treated by repositioning the dislocation. Medications are usually prescribed to reduce inflammation and relieve pain.

Physiotherapy is often prescribed.

Sacroiliitis is an inflammatory process in the sacroiliac joint. It can be an independent disease or a symptom of other diseases of an infectious or autoimmune nature. Usually sacroiliitis develops on one side. Bilateral sacroiliitis can be observed with brucellosis (less often with tuberculosis) and is a constant symptom in Bechterew's disease. The treatment plan and prognosis depends on the form and causes of sacroiliitis.
The sacroiliac joint is a sedentary articulation through which the pelvis is connected to the spine with the help of ear-shaped joints located on the lateral surfaces of the sacrum. The joint is held by the strongest ligaments of the human body - the interosseous sacro-lumbar ligaments, short wide bundles that are attached to the sacrum on one side and to the iliac tuberosity on the other.
The sacrum is the second section of the spine from the bottom (below it is the coccyx). In children, the sacral vertebrae are located separately from each other. Then, at the age of 18-25, these vertebrae fuse together, forming a single massive bone. With congenital malformations (back bifida), fusion may be incomplete.

Nonspecific (purulent) sacroiliitis.

sacroiliitis in tuberculosis.

sacroiliitis in syphilis.

Sacroiliitis in brucellosis.

Aseptic (infectious-allergic) sacroiliitis.

Sacroiliitis of non-infectious nature.