PMC8516381_01
AP plain radiographic of the pelvis and sacroiliac joints revealed minor widening of the symphysis pubis and no other abnormalities.
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ESR mm/h.
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Laboratory testing found 6.85 white blood cells (WCC) G/l with 69.2% neutrophils, a 48 mm/h elevated erythrocyte sedimentation rate (ESR) (Figure 2), normal procalcitonin (0.02), and a 68.7 mg/L elevated C- reactive protein (Figure 3).
CRP mg/L.
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Laboratory testing found 6.85 white blood cells (WCC) G/l with 69.2% neutrophils, a 48 mm/h elevated erythrocyte sedimentation rate (ESR) (Figure 2), normal procalcitonin (0.02), and a 68.7 mg/L elevated C- reactive protein (Figure 3).
Pelvic MRI on admission showing bone marrow edema (arrowheads), small intraarticular fluid (arrow) and muscle edema-like change, myositis (asterisk).
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CT-guided right SI joint needle aspiration in the left lateral position.
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Because it was impossible to place the patient in the prone position on the same day, CT-guided aspiration of the right SIJ was performed in the left lateral position (Figure 5), but no aspirated fluid was obtained; however, SIJ block was performed using 20 mL of 0.25% bupivacaine after which she briefly noticed some relief of her shooting pain.
A pelvic MRI a year later revealed normal bone marrow signal and normal surrounding muscle. There are no fluids within the joints.
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Her 1-year follow-up MRI was uneventful (Figure 6), while she did have periodic minor right-sided LPP that did not interfere with her daily activities.