Re: Concomitant Bilateral Sacroiliitis and Lumbar Spondylodiscitis Secondary to Staphylococcus aureus Sepsis

We read with great interest the case report by Gzda and Hzal describing Staphylococcus aureus bacteremia complicated by concomitant bilateral sacroiliitis and lumbar spondylodiscitis. 1 The authors are to be commended for presenting this rare co-occurrence, as infectious sacroiliitis remains a diagnostic challenge due to its nonspecific clinical presentation and frequent overlap with inflammatory spondyloarthritis.In this regard, magnetic resonance imaging (MRI) may help distinguish infectious from inflammatory sacroiliitis: infectious cases typically show asymmetric bone marrow edema, periarticular soft-tissue inflammation, and occasionally abscess formation, whereas inflammatory sacroiliitis tends to present with symmetric involvement and chronic structural lesions.