Sacroiliac Joint Dysfunction & Injection

The sacroiliac joint is a diarthrodial synovial joint with abundant innervation and capability of being a source of low back pain and referred pain in the lower extremity. There are no definite historical, physical, or radiological features to provide definite diagnosis of sacroiliac joint pain, although many authors have advocated provocational manoeuvers to suggest sacroiliac joint as a pain generator. An accurate diagnosis can be made by controlled sacroiliac joint diagnostic blocks.. Intraarticular injections, and radiofrequency neurotomy have been described as therapeutic measures. The SI joint is a real yet underappreciated pain generator in an estimated 15% to 25% of patients with axial LBP. Whereas historical and physical examination findings have been previously advocated as useful tools in identifying patients with SI joint pain, more recent studies have demonstrated they have limited diagnostic value. Presently, small-volume diagnostic blocks remain the most commonly used method for diagnosing this disorder, although their validity remains unproven. Intra articular and peri articular corticosteroid injections have been shown in most, but not all, studies to provide good to excellent pain relief lasting up to 10 months in patients with and without spondylarthropathy.