Eight children with low back, hip, or lower limb pain who were subsequently shown to have pyogenic infections of their sacroiliac joints were examined by a combination of plain roentgenography and radionuclide bone scintigraphy. In all cases, the scintigraphic examination was diagnostic, while the roentgenograms were initially abnormal in only two cases. In the other six cases, one to six weeks passed before changes compatible with sacroiliac pyarthrosis were seen on roentgenographic examination. Radionuclide scintigraphy is recommended as part of the initial workup of children with appropriate symptoms.
(JAMA 238:2701-2704, 1977)