Minimally Invasive Sacroiliac Joint Fusion for the Treatment of Brucella Pyogenic Sacroiliitis: A Case Report

Abstract

A 39-year-old male presented with a two-month history of right hip pain. Computed tomography (CT) scan demonstrated right sacroiliac joint space widening with cortical destruction and erosive changes in the iliopsoas muscle. Minimally invasive right sacroiliac joint fusion was performed with biopsy and aspirate, which confirmed positive Brucella cultures. The patient was started on long-term antibiotic therapy, and his pain significantly improved. Pyogenic sacroiliitis is a rare condition that requires a high index of suspicion. In this case, minimally invasive sacroiliac joint fusion successfully treated the patient's pain and instability as well as aided in the diagnosis of Brucella infection.

Keywords: brucella; pyogenic sacroiliitis; sacroiliac joint; sacroiliac joint fusion; sacroiliitis.

Figure 1. Axial and coronal computed tomography (CT) views showing right sacroiliac joint cortical destruction, erosive changes, and widening.

Figure 1a: Axial view showing sacroiliac joint cortical destruction, erosive changes, and widening. Figure 1b: Coronal view showing sacroiliac joint cortical destruction, erosive changes, and widening.

Figure 2. Preoperative magnetic resonance imaging (MRI) displaying right sacroiliac joint effusion with edema

Figure 3. Six-month anteroposterior X-ray displaying the correct placement of implants