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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can A High ASO Titer From A Streptococcal Infection Cause Sacroiliitis?

Hello. I m 24y/F. I have been diagnosed with Sacroilitits recently. ESR is 50 and ASO titer is 302, vitamin D is 13 and with normal CBC. MRI shows normal SI joints. My neurosurgeon has advised me to take corticosteroids. I still have inflammation and severe pain in my si joints, it s been two months. My question is what is the cause for my condition, does streptococcal infection causes Sacroilitits as my ASO is high? And if yes how is Sacroilitits caused my streptococcus treated? Do I need to get some other blood tests to confirm it?
posted on Mon, 15 Apr 2024
Twitter Wed, 24 Sep 2025 Answered on
Twitter Tue, 30 Sep 2025 Last reviewed on
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General & Family Physician,  's  Response
Hello,

Since your MRI doesn’t show sacroiliitis, but according to the reports vitamin D is very low, your pain may be from vitamin D deficiency and inflammation. You are advised to correct vitamin D deficiency. Though you do have past strep infection but it may not be the cause of your sacroiliitis.

Get clinically examined by your local doctor and get tests done to confirm or rule out post-streptococcal reactive arthritis. Repeat ASO or anti-DNase B titers to confirm if strep infection is recent/active.

If it’s infectious sacroiliitis. You are advised hospital evaluation, joint aspiration, and prolonged IV antibiotics. Consult a rheumatologist and get done all required tests like HLA-B27 (for spondyloarthritis), ANA, RF, anti-CCP if autoimmune arthritis suspected so that you can be treated at the earliest.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Nupur K., General & Family Physician
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Can A High ASO Titer From A Streptococcal Infection Cause Sacroiliitis?

Hello, Since your MRI doesn’t show sacroiliitis, but according to the reports vitamin D is very low, your pain may be from vitamin D deficiency and inflammation. You are advised to correct vitamin D deficiency. Though you do have past strep infection but it may not be the cause of your sacroiliitis. Get clinically examined by your local doctor and get tests done to confirm or rule out post-streptococcal reactive arthritis. Repeat ASO or anti-DNase B titers to confirm if strep infection is recent/active. If it’s infectious sacroiliitis. You are advised hospital evaluation, joint aspiration, and prolonged IV antibiotics. Consult a rheumatologist and get done all required tests like HLA-B27 (for spondyloarthritis), ANA, RF, anti-CCP if autoimmune arthritis suspected so that you can be treated at the earliest. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K., General & Family Physician