Miliary tuberculosis presented as a sacroiliitis: a case report
Ali Utkan, Kemalettin Gülbahçe, Asım Cılız, Mehmet Ali Tümöz
Ankara Numune Eğitim ve Araştırma Hastanesi 2. Ortopedi ve Travmatoloji Kliniği, Ankara, Türkiye
Keywords: Key words: Miliary tuberculosis; sacroiliac joint; tuberculous sacroiliitis.
Miliary tuberculosis is a clinical picture due to hematogenous dissemination of a very large amount of bacilli. We present a case with miliary tuberculosis in which the diagnosis and treatment was delayed due to focusing on complaints about the sacroiliac joint. The 28-year-old male patient was admitted with a five-month history of pain in his left sacroiliac joint which was not traumatic. As a definitive diagnosis could not be reached by means of laboratory tests performed, an open biopsy was planned. In the chest X-ray obtained for routine preoperative evaluation, diffuse, bilateral opacities with a 1-2 mm radius were detected and the case was diagnosed with miliary tuberculosis. Miliary tuberculosis is a disease involving multiple organs and systems and treatment can be started empirically as microbiologic verification is difficult. Sacroiliac joint infections are rare and diagnosis is often delayed. The diagnosis of bone and joint tuberculosis is hard because of relative rarity of the disorder, the wide variety in clinical presentation, low suspicion of the examining physician, and rare diagnostic findings on radiographs. This case report highlights the importance of continued awareness for early detection and treatment of a tuberculous sacroiliac joint infection.