Tuberculoussacroilitis a rare cause of refractory low back ache - case report

Tuberculosis of sacroilic joints is a very rare cause of low back ache radiating to the thigh and requires a high index of suspicion for its diagnosis. Magnetic resonance imaging   is key to early diagnosis of this condition which may prevent further complications associated with it .It is  difficult to diagnose due to the vague and non-specific presentations. In a patient presenting with a unilateral destructive sacroiliac lesion, tuberculosis should always be in the differential diagnosis along with psoriatic arthropathy, Reiter's syndrome, and rheumatoid arthritis. The  classical presentation of ankylosing spondylitis is that of bilateral, symmetric involvement of sacroiliac joints, whereas unilateral pathology is  more typical of infection. Unlike pyogenic, tuberculous osteomyelitis arises insidiously, and takes a chronic course that can be destructive and resistant to control.