Exercise-related stress reaction of the sacroiliac joint

Abstract

Low back pain, secondary to a variety of musculoskeletal injuries, is common in individuals engaged in athletics. Sports-related stress reactions of the pars interarticularis are not uncommon. Stress reactions of the sacroiliac joint, on the other hand, are considered very rare. The limitations of plain radiographs and the ability of bone scintigraphy to detect stress lesions in athletes is well documented. In this paper we describe four young athletes with stress reactions of the sacroiliac region. We consider these to be uncommon but not rare, and probably self-limiting. Accurate diagnosis is important, however, to exclude more important causes of low back pain that require therapy. This type of injury also results in abnormal stresses to the lower extremities which can result in an independent and more serious injury. All sacroiliac stress reactions were unsuspected and were diagnosed only by bone scintigraphy after plain radiographs were noncontributory.

Computed Tomographic Evaluation of the Sacroiliac Joints of Young Working Labrador Retrievers of Various Work Status Groups: Detected Lesions Vary Among the Different Groups and Finite Element Analyses of the Static Pelvis Yields Repeatable Measures of Sacroiliac Ligament Joint Strain

“…Rigorous training in repetitive agility-type motions in young dogs has also been proposed to increase the likelihood of developing chronic joint injuries later in life due to the under-developed physes (6). In people, this premise has been supported, given that most spinal injuries in young athletes have been found to occur after a sudden increase in the intensity and frequency of training (7)(8)(9). This clinical problem has been termed "overtraining" (10).…”

“…This clinical problem has been termed “overtraining” ( 10 ). Bone scintigraphy of the sacroiliac joint (SIJ) in young human athletes reporting lower back pain showed increased radiopharmaceutical uptake in one or both joints signifying increased bone turnover in athletes reporting lower back pain without any known specific trauma or reported radiographic abnormalities ( 7 , 9 ). Cumulative musculoskeletal injuries are the most common injuries among working dogs and an important cause of early retirement ( 1 , 3 , 4 ).…”

Sacroiliac dysfunction

“…Os praticantes de corrida e os recrutas militares podem apresentar fraturas por tensão no sacro, no íleo ou em ambos (48) , e as fraturas por insuficiência são uma complicação da pelve osteoporótica (16) . Mais uma vez, a cintilografia óssea pode ser útil no diagnóstico destas duas enfermidades (31,43) .…”

“…Stress fractures of sacrum, ilium or both can occur in runners and military recruits (48) , and insufficiency fractures are a complication of osteoporotic pelvis (16) . Again, bone scanning can be helpful in the diagnosis of these two conditions (31,43) .…”

<p>A Review and Algorithm in the Diagnosis and Treatment of Sacroiliac Joint Pain</p>

“…In addition to the etiologic sources, there are numerous factors that can predispose a person to gradually develop SI joint pain. Risk factors that increase stress on the SI joint are leg length discrepancy, 8 gait abnormalities, 9 prolonged vigorous exercise, 10 scoliosis, 11 pregnancy, 12,13 spinal fusion to the sacrum, 14 and hip pathology. 15,16…”