Pyarthrosis and Abscess of the Sacroiliac Joint

Cure Arthritis Naturally

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The sacroiliac joint may be infected through the hematogenous route, from a contiguous focus, or by direct bacterial implantation from

Radial Head Arthritis

Fig. 8.16A, B Acute infective arthritis of the elbow. A Lateral pinhole scan of the right elbow in a 31-year-old male shows intense tracer uptake in the radial head (rh), olecranon base (ob), and olecranon fossa (of). B Lateral radiograph reveals diffuse blurring of the joint with thickening of the cubital soft tissue overlying the olecranon (arrowheads)

Fig. 8.16A, B Acute infective arthritis of the elbow. A Lateral pinhole scan of the right elbow in a 31-year-old male shows intense tracer uptake in the radial head (rh), olecranon base (ob), and olecranon fossa (of). B Lateral radiograph reveals diffuse blurring of the joint with thickening of the cubital soft tissue overlying the olecranon (arrowheads)

biopsy, surgery, or a traumatic wound. As in the endarteries of the long-bone ends, the sub-chondral blood circulation in the ilium is slow, facilitating bacterial lodgment in the synovi-um. The pyogenic infection of the sacroiliac joint is typically unilateral (Gordon and Kabins 1980). The infection rapidly spreads and dissolves the cartilages and bones, often causing apparent joint space widening. The destroyed joint is replaced by granulation tissue and fi-brosis with marginal reactive sclerosis.

Pics Toe Joint Infection

Fig. 8.17A, B Pyogenic arthritis of a small digital joint. A Dorsoplantar scan of the left foot in a 15-year-old girl with acute infection in the first toe shows marked tracer uptake in the bones around the metatarsophalangeal joint (arrow). B Radiograph reveals narrowed joint space with blurring and marked periarticular soft tissue thickening (arrow)

Fig. 8.17A, B Pyogenic arthritis of a small digital joint. A Dorsoplantar scan of the left foot in a 15-year-old girl with acute infection in the first toe shows marked tracer uptake in the bones around the metatarsophalangeal joint (arrow). B Radiograph reveals narrowed joint space with blurring and marked periarticular soft tissue thickening (arrow)

Staph Infection Toe Pictures

Fig. 8.18 Intense tracer uptake in the regional osteoporosis of the femoral head simulating pyogenic infection. Anterior pinhole scintigraph of the left hip in a 34-year-old woman with pain shows extremely intense tracer uptake in the femoral head. Importantly, unlike in infection, the tracer uptake is exclusively confined to the femoral head and other bones are completely free. Ordinary spot scintigraph did not provide such crucial information

Radiographically, the acute or subacute pyo-genic infection of the sacroiliac joint manifests as either apparent widening of the joint space and blurring or erosion of the subchondral bones (Fig. 8.19A). If an abscess forms it presents as a bone defect surrounded by irregular sclerotic margin (Fig. 8.20A), strongly resembling tuberculosis (see Sect. 8.2.3).

Pinhole scan findings differ according to the disease stage. In the acute stage, spinnaker-like uptake appears in the lower synovial compartment (Figs. 8.19B) and in the chronic stage with abscess formation uptake becomes bizarre containing a photopenic defect (Fig. 8.20B). It is to be noted that the scintigraphic finding of acute pyarthrosis of the sacroiliac joint radically differs according to the sacral inclination relative to the coronal plane of the body. Thus,

Sacroiliac Joint Infection

Fig. 8.19A, B Subacute pyogenic infection of the sacroiliac joint. A Anteroposterior radiograph of the left sacroiliac joint in a 19-year-old female shows apparent joint space widening with erosion and blurring of subchondral bones characteristically in the synovial lower compartment (open arrows). B Anterior pinhole scan reveals vertically aligned intense bar-like uptake of the synovial sac-roiliac joint (arrows)

Fig. 8.19A, B Subacute pyogenic infection of the sacroiliac joint. A Anteroposterior radiograph of the left sacroiliac joint in a 19-year-old female shows apparent joint space widening with erosion and blurring of subchondral bones characteristically in the synovial lower compartment (open arrows). B Anterior pinhole scan reveals vertically aligned intense bar-like uptake of the synovial sac-roiliac joint (arrows)

Infected Sacroiliac Joint

Fig. 8.20A, B Abscess formation in chronic pyogenic sacroiliitis. A Anteroposterior radiograph of the left sac-roiliac joint in a 65-year-old female with a chronic infection developed after hysterectomy performed 4 months previously shows large irregular gaping bone destruction (open arrow) with prominent marginal reactive bone formation (arrowheads). Note two small metallic surgical clips. B Anterior pinhole scan reveals a photon defect due to an abscess (open arrow) surrounded by prominent tracer uptake in sclerosis (arrowheads)

Fig. 8.20A, B Abscess formation in chronic pyogenic sacroiliitis. A Anteroposterior radiograph of the left sac-roiliac joint in a 65-year-old female with a chronic infection developed after hysterectomy performed 4 months previously shows large irregular gaping bone destruction (open arrow) with prominent marginal reactive bone formation (arrowheads). Note two small metallic surgical clips. B Anterior pinhole scan reveals a photon defect due to an abscess (open arrow) surrounded by prominent tracer uptake in sclerosis (arrowheads)

Tilted Sacrum
Fig. 8.21 Subacute pyogenic sacroiliitis. Anterior pinhole scan of the pelvis in a 33-year-old man with right pyogenic sacroiliitis shows intense tracer uptake in the lower aspect of the joint (arrow). Minimal reaction is also seen in the sacral border

when the sacrum is flat the uptake appears to be elongated club shaped (Fig. 8.19B), but if posteriorly tilted (sacrum acutum) the uptake becomes roundish in appearance (Fig. 8.21).

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Arthritis Joint Pain

Arthritis Joint Pain

Arthritis is a general term which is commonly associated with a number of painful conditions affecting the joints and bones. The term arthritis literally translates to joint inflammation.

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