Sacroiliac joint (SIJ) pain
The sacroiliac joint (SIJ) is a synovial joint.
- prevalence of sacroiliac joint pain in patients presenting with lower back pain ranges from 15% to 25%
- SIJ pain can result from either intra-articular causes, for example arthritis or infection, or extraarticular causes, including enthesopathy, ligamentous injury, fractures ormyofascial pain
- SIJ pain cannot be diagnosed from history or physical examination alone, and X-ray and MRI are necessary
Treatment
- initial treatment should involve non-invasive measures such as anti-inflammatory medications and physiotherapy, focussing on exercises to improve lumbopelvic stability
- invasive treatment, which involves injection of the SIJ, can also be used in the diagnosis of SIJ pain
- blind injections are unreliable and not recommended
- radiologically guided SIJ injections can provide pain relief for up to 1 year (1)
- injections are performed under fluoroscopy or CT or MRI guidance or more recently, realtime, high-resolution ultrasound guidance.
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