Chronic sciatica caused by tuberculous sacroiliitis. A case report.

STUDY

DESIGN

This is a case report.

OBJECTIVES

To report and discuss a case of tuberculosis sacroiliitis with anterior synovial cyst presenting as chronic sciatica.

SUMMARY OF BACKGROUND DATA: This is a report of clinical manifestation, physical findings, computed tomography scan, and results after surgical treatment in a 58-year-old woman with tuberculous sacroiliitis, which caused chronic sciatica.

METHODS

The physical findings, laboratory data, radiographs, and computed tomography scan of sacroiliac joints were studied. Sacroiliitis with anterior synovial cyst was shown in computed tomography scan. Posterior arthrotomy and drainage of the synovial cyst were performed. After surgery, she was treated with three combined antituberculosis drugs for 9 months.

RESULTS

Löwenstein-Jensen culture and histologic examination confirmed the diagnosis of tuberculous sacroiliitis. At 3 years, she had no back pain or sciatica and a complete functional recovery.

CONCLUSIONS

Tuberculous sacroiliitis with anterior synovial cyst is a rare cause of chronic sciatica. Lateral compression of the pelvis, Gaenslen's test, and Patrick's test should be included in evaluation of patients with sciatica. Computed tomography scan is a superb diagnostic method for sacroiliitis. Arthrotomy and drainage effectively relieve the sciatica. Three combined antituberculosis drug therapy should be given after surgery.