Postpartum pyogenic sacroiliitis

Abstract

Back and buttock pain is a common and nonspecific problem that frequently occurs
during pregnancy and the postpartum period. Generally, this pain improves on its
own and rarely causes complications. Septic sacroiliitis, on the other hand, is an
inflammation of the sacroiliac joint caused by microbial invasion of the synovial
space. Pyogenic sacroiliitis coexisting with pregnancy, although rare during the
peripartum period, is associated with significant morbidity and mortality. Timely
diagnosis can be difficult due to the nonspecific symptomatology of the disease. It
is characterized by sacroiliac joint tenderness, difficulty walking, and progressive,
lancinating low back pain that may radiate to the buttocks. In addition, increased
serum concentrations of inflammatory markers are observed. Magnetic resonance
imaging may show edematous changes in the sacroiliac joint. Intravenous antibiotic
therapy is the first-line treatment for patients diagnosed with pyogenic sacroiliitis,
preventing the occurrence of severe joint complications. A case of postpartum
pyogenic sacroiliitis is presented.