Treatment strategy for sacroiliac joint-related pain at or around the posterior superior iliac spine

Eiichi Murakami, Daisuke Kurosawa, Toshimi Aizawa

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective Pain at or around the posterior superior iliac spine (PSIS) is characteristic of sacroiliac joint (SIJ) -related pain. This pain can be treated by either a peri- or intra-articular injection into the joint, with the former being much easier to perform. We investigated whether peri- or intra-articular injections were more frequently effective in patients with SIJ-related pain, and aimed to create an efficient treatment strategy for SIJ-related pain at or around the PSIS. Design Prospective case–control study. Patients and methods We evaluated 85 patients with pain at or around the posterior superior iliac spine as indicated by the one finger test. First, we performed a peri-articular sacroiliac joint injection. If it was ineffective, an intra-articular injection was later given. Groin pain, sitting pain, sacroiliac joint shear test results, and posterior superior iliac spine and sacro-tuberous ligament tenderness were also compared between patients for whom a peri- or intra-articular injection was effective. Results Seventy-two (85%) of 85 patients had an effective injection. Out of these 72 patients, 58 (81%) had a positive peri-articular injection and 14 (19%) had a positive intra-articular injection. Four items, excluding tenderness of the sacro-tuberous ligament had no significant difference between these two injection types. Conclusion To treat sacroiliac joint-related pain at or around the posterior superior iliac spine, a peri-articular injection should be performed first, and only if it is not effective should an intra-articular injection be administered. Using this strategy, we expect that most patients with sacroiliac joint-related pain will be efficiently diagnosed and treated.

Original languageEnglish
Pages (from-to)43-46
Number of pages4
JournalClinical Neurology and Neurosurgery
Volume165
DOIs
Publication statusPublished - 2018 Feb

Keywords

  • Intra-articular injection
  • One-finger test
  • Pain
  • Peri-articular injection
  • Sacroiliac joint

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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