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2022
ВЕСТНИК САНКТ-ПЕТЕРБУРГСКОГО УНИВЕРСИТЕТА МЕДИЦИНА
Т. 17. Вып. 1
МЕДИЦИНСКАЯ ВИЗУАЛИЗАЦИЯ
UDC 616.728.16-002-07
Simultaneous sacroiliitis and symphysitis pubis
J. F. de Carvalho
Hospital Universitario Professor Edgard Santos, Federal University of Bahia, Rua Augusto Viana, Palacio da Reitoria, Canela, Salvador, 40110-909, Brazil
For citation: De Carvalho J. F. Simultaneous sacroiliitis and symphysitis pubis. Vestnik of Saint Petersburg University. Medicine, 2022, vol. 17, issue 1, pp. 63-65. https://doi.org/10.21638/spbu11.2022.107
This is the description of a rare, documented association of sacroiliitis with symphysitis pubis.
A 37-year-old woman experienced low back pain since 2009 with inflammatory characteristics (worse at rest, improvement during movement) associated with morning stiffness of 2 hours. Her X-ray demonstrated sacroiliitis. A magnetic resonance image (MRI) showed bilateral bone edema of the sacroiliac joints with enhancement after gadolinium injection (Fig. 1). At the same time, a magnetic resonance image revealed edema on her symphysitis pubis better showed after contrast infusion and reduction of joint space (Fig. 2). HLA-B27 was positive. C-reactive protein and erythrocyte sedimentation rate were within normal range, 0.44 mg/l and 11 mm/1st hour, respectively. Rheumatoid factor and antinuclear antibodies were negative. A diagnosis of spondyloarthritis was made and she was treated with non-steroidal antiinflammatory drugs. She experienced slight improvement of her symptoms and she is waiting for anti-TNF therapy.
Spondyloarthritis patients may have involvement of their symphysitis pubis. In fact, Helliwell et al. [1] have radiologically evaluated 91 subjects with spondyloarthritis and revealed that 31 % of ankylosing spondylitis patients, 30 % of enteropathic spondyloarthritis, 25 % of psoriatic arthritis and 14 % of reactive arthritis have symphisitis. The authors performed single radiographies in that study. We were not able to find any study that evaluated the frequency of symphisitis pubis in spondyloarthritis patients using modern techniques such as MRI. Recently, we described a case of symphisitis pubis after pregnancy [2].
© St Petersburg State University, 2022 https://doi.org/10.21638/spbu11.2022.107
Fig. 1. Magnetic resonance imaging T2 signal demonstrating irregularities, bone marrow edema and synovitis of sacroiliac joints
Fig. 2. Magnetic resonance imaging T2 signal demonstrating irregularities, subcortical cysts, bone marrow edema of symphysitis pubis
Acknowledgments
This study was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico — CNPQ (grant 300665/2009-1 to JFC) and by a Federico Foundation Grant to JFC.
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References
1. De Carvalho J. F., Brandao R. A., Faillace C. Recurrent symphysitis pubis. Acta Reumatol Port., 2011, vol. 36, pp. 418-419.
2. Helliwell P. S., Hickling P., Wright V Do the radiological changes of classic ankylosing spondylitis differ from the changes found in the spondylitis associated with inflammatory bowel disease, psoriasis, and reactive arthritis? Ann Rheum Dis., 1998, vol. 57, pp. 135-140.
Received: February 2, 2022 Accepted: March 24, 2022
Author's information:
Jozelio Freire de Carvalho — MD, PhD, Professor; jotafc@gmail.com
Одновременные сакроилеит и лобковый симфизит
Ж. Ф. де Карвальо
Университетская больница профессора Эдгарда Сантоса, Федеральный университет Баии,
Бразилия, 40110-909, Сальвадор, Канела, Паласио да Рейториа, Руа Аугусто Виана
Для цитирования: De Carvalho J. F. Simultaneous sacroiliitis and symphysitis pubis // Вестник Санкт-Петербургского университета. Медицина. 2022. Т. 17. Вып. 1. С. 63-65. https://doi.org/10.21638/spbu11.2022.107
Статья поступила в редакцию 2 февраля 2022 г.; рекомендована к печати 24 марта 2022 г.
Контактная информация:
Де Карвальо Жозелио Фрейре — д-р мед. наук, проф.; jotafc@gmail.com
Вестник СПбГУ. Медицина. 2022. Т. 17. Вып. 1
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