Background: We describe our diagnostic sacroiliac joint (SIJ) injection technique under the guidance of three-dimensional cone beam computed tomography (3D-CBCT) fused with real-time fluoroscopy.
Methods: A retrospective review of 17 patients (mean age 55.4 (range 40-74) years) who received a total of 23 diagnostic SIJ injections between March 2016 and November 2017 were performed. Pre- and post-procedure pain scores were reviewed from the medical records and then these findings were correlated with which patients were and were not diagnosed with SIJ pain by clinical management. The final diagnosis of SIJ-related pain was made in cases with at least 50% symptomatic improvement following SIJ-specific pain treatments.
Results: Some 87% (n=20/23) of injections achieved more than 50% pain relief after the diagnostic SIJ injection. The final diagnosis of the target SIJ-related pain after follow-up and management was found in 90% (n=18/20) of cases. There were two cases with positive tests diagnosed as non-SIJ pain including one with the diagnosis of femuroacetabular impingement and one with pain related to loosening of knee hardware. The sensitivity, specificity, positive predictive value, and negative predicative value of diagnostic SIJ injections were 100%, 60%, 89%, and 100%, respectively, with a 40% false-positive rate. There were no procedure-related complications.
Conclusion: 3D-CBCT fused with real-time fluoroscopy for SIJ injection is accurate and safe.
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http://dx.doi.org/10.1136/neurintsurg-2020-016212 | DOI Listing |
J Bone Joint Surg Am
December 2024
Division of Orthopedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada.
➢ Low back pain has a lifetime incidence of up to 84% and represents the leading cause of disability in the United States; 10% to 38% of cases can be attributed to sacroiliac joint (SIJ) dysfunction as an important pain generator.➢ Physical examination of the SIJ, including >1 provocation test (due to their moderate sensitivity and specificity) and examination of adjacent joints (hip and lumbar spine) should be routinely performed in all patients presenting with low back, gluteal, and posterior hip pain.➢ Radiographic investigations including radiographs, computed tomography, and magnetic resonance imaging with protocols optimized for the visualization of the SIJs may facilitate the diagnosis of common pathologies.
View Article and Find Full Text PDFCurr Rheumatol Rep
December 2024
Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 143-729, Republic of Korea.
Purpose Of Review: We aimed to introduce recent finding of imaging studies used in axial spondyloarthritis (axSpA).
Recent Findings: Using low-dose whole spine CT (CT syndesmophyte score [CTSS]) improved diagnostic accuracy for evaluating spinal structural progression than previous method (modified Stoke Ankylosing Spondylitis Spinal Score [mSASSS]) in axSpA. The novel definition of positive finding of sacroiliac joint (SIJ) and spine magnetic resonance imaging (MRI) enabled to diagnose axSpA earlier than plain radiography.
Tech Vasc Interv Radiol
September 2024
Interventional Spine Services, Comprehensive Specialty Care, Edmond, OK.
The sacroiliac joint (SIJ) is the largest diarthrodial joint in the human body and accounts for approximately 20% of all low back pain, which is commonly seen in patients with lumbosacral fusions. Despite this, SIJ dysfunction often poses a challenging diagnosis depending on clinical evaluation, imaging, and image-guided joint injection. SIJ fusion is an effective and safe method of treatment, with minimally invasive approaches fitting well within the armamentarium of interventional radiologists treating chronic pain and other musculoskeletal conditions.
View Article and Find Full Text PDFSci Rep
September 2024
Department of Orthopaedic Surgery, Zuyderland Medical Center, Henri Dunantstraat 5, 6130 MB, Heerlen, The Netherlands.
During the first postoperative days following minimally invasive sacroiliac joint fusion (MISJF), patients often report serious pain, which contributes to high utilization of painkillers and prevention of early mobilization. This prospective, double-blind randomized controlled trial investigates the effectiveness of intraoperative SIJ infiltration with bupivacaine 0.50% versus placebo (NaCl 0.
View Article and Find Full Text PDFExpert Rev Neurother
November 2024
Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, Bolzano, Italy.
Introduction: Spinal and non-spinal pathologies can cause low back pain. Non-spinal sources of low back pain include the sacroiliac joint (SIJ) and the hip. SIJ pain can be treated either conservatively or surgically.
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