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oral nonsteroidal anti-inflammatory drugs.
27%
124/467
intravenous antistaphylococcal antibiotics.
44%
205/467
incision and debridement of the retroperitoneal abscess.
5%
25/467
incision and debridement of the left sacroiliac joint.
22%
104/467
arthrotomy and irrigation of the left hip joint.
1%
3/467
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The symptoms, physical findings, and laboratory studies are most consistent with a diagnosis of infectious sacroiliitis, usually caused by Staphylococcus aureus. Initial radiographs will be normal, and the diagnosis of sacroiliitis is often delayed. A technetium Tc 99m bone scan will localize the problem in 90% of patients but may occasionally give a false-negative result in early cases. If suspicion is high, a gallium scan or MRI scan may help confirm the diagnosis of sacroiliitis. Needle aspiration of the sacroiliac joint is difficult; therefore, antibiotic selection is usually empiric or based on blood cultures. Sacroiliitis that is the result of connective tissue inflammatory disease is usually bilateral and without fever or leukocytosis. The lack of hip irritability, spinal rigidity, and abdominal tenderness helps to rule out other causes of limping with fever, such as psoas abscess, diskitis, and septic hip.
1.3
(27)
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