关键词: 结核,骨关节/诊断, 结核,骨关节/外科学, 骶髂关节, 抗结核药, 预后

Abstract: Objective  To discuss diagnosis methods and curative effect for the early sacroiliac joint tuberculosis. Methods  Twenty patients with early sacroiliac joint tuberculosis from February 2005 to June 2011 in the Second Hospital of Peking Armed Police were enrolled. Diagnosis was primarily identified by clinical manifestations,imaging features and biopsy, with the kim type Ⅱ8 cases, type Ⅲ12 cases. Patients received intralesional curettage and autologous bone grafting.To observe the effect of the treatment, Majeed rating system was used, in which score was evaluated from five aspects including the pain (30 points), work (36 points), seating (10 points), sex (4 points) and stand (20 points).The total score is 100 points and clinical classification is evaluted by calculating the total points: optimal（>85 points）, good(70-84 points), medium(55-69 points), poor（<55 points）. For all the cases’ preoperative Majeed score, no patients reached optimal, 2 got good level, 14 cases got medium level, and 4 cases was poor. Results  Twenty patients were followed up for 12 to 36 months. No patients developed recurrence, infection and dislocation of sacroiliac joint complications such as dislocation, all patients resumed normal training and attendance after 3－6 months. Preoperative Majeed scoring average was(61.75±6.54) points, the final follow-up average of (92.75±3.70) points with significantly difference（t=3.481，P<0.001）. Conclusion  Early sacroiliac joint tuberculosis can be diagnosed early by clinical manifestations, imaging features and biopsy. Patients can obtain satisfactory curative effect by receiving system standard antituberculosis drugs and operation treatment.

Key words: Tuberculosis, osteoarticular/diagnosis, Tuberculosis, osteoarticular/surgery, Sacroiliac joint, Antitubercular agents, Prognosis