[Infectious sacroiliitis. Multicenter study of 214 cases].

Out of 214 cases of infective sacro-ileitis observed on Rheumatology Units, 65% were due to common bacteria, 25% were tuberculous and 10% due to brucellosis. Post-partum infections were early, severe and often due to streptococci. Sacrocoxalgia was accompanied in 50% of cases by another focus of active tuberculosis. Two clinical presentations are possible, either that of acute sacro-ileitis with a sudden onset, severe pain, frank infection and major impotence which is common in infections due to current bacteria; or the presentation may be that of subacute sacro-ileitis with progressive onset with little or no fever, pain and moderate impotence which may be due to any bacteria. Identification of the responsible organism depends on blood culture, bacterial sampling at the point of entry of the infection but, above all, direct swab or preferably needle biopsy. Bone scan may demonstrate early hyperfixation in the absence of any radiological signs. Prolonged antibiotic treatment is sufficient in most cases.