Sacroiliac Joint Pain

Dreyfuss, Paul; Dreyer, Susan J.; Cole, Andrew J.; Mayo, Keith

doi:10.5435/00124635-200407000-00006

Cited by 254 publications

(159 citation statements)

References 30 publications

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“…There have been many studies conducted to confirm the reliability and validity of these tests; however, results have varied greatly and are often contradictory [1,2,5,[10][11][12][13][14][15][16][17][18]. Once the diagnosis is made, patients are generally treated non-operatively with pain control, chiropractic mobilization of the joint, physical therapy, and/ or joint injections [19]. Many physicians use the intraarticular injection as a diagnostic tool [6,16].…”

Section: Introductionmentioning

confidence: 99%

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Documentation of outcomes for sacroiliac joint fusion: does prior spinal fusion influence the outcome?

2013

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Purpose The purpose of this prospective case series (level II) was to determine the clinical outcomes of anterior SIJ fusion, comparing the outcomes of patients who had prior spinal fusions at any level compared to patients who have not. Methods This prospective study included 25 patients who underwent SIJ fusion with anterior plate fixation. All patients had failed non-operative treatment, had a positive Patrick test, and positive response to intra-articular SIJ injections with greater than 50 % pain relief. Patients had follow-up at 3, 6, 9 and 12 months where they completed Oswestry disability index (ODI) and Short Musculoskeletal Functional Assessment (SMFA) surveys. Outcome data are available for 19 patients who completed pre-operative and 12-month follow-up surveys. Their average time of the final follow-up was 1.1 years (range 10-33 months). Results Significant improvements between pre-operative and the final follow-up in ODI (p = 0.007) and SMFA (p = 0.01) were observed; the ODI assessed outcomes in patients who had previous spinal fusion surgery were significantly worse than those that did not at the final followup (p = 0.04). Conclusion Patients who have not undergone prior spinal fusion surgery, regardless of age, gender, and BMI have better outcomes following anterior SIJ fusion.

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Section: Introductionmentioning

confidence: 99%

“…If patients receive 50-100 % relief of their symptoms following the injections it is generally considered pathognomonic for pain originating from the SIJ. Should these modalities fail to bring acceptable long lasting improvement in the patient's symptoms, the final option is SIJ arthrodesis [19].…”

Section: Introductionmentioning

confidence: 99%

Documentation of outcomes for sacroiliac joint fusion: does prior spinal fusion influence the outcome?

2013

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“…22,23 Despite the difficulty in differentiating these anatomical structures through history and physical examination findings, several significant clinical features have been identified. Centralization of symptoms from repeated lumbar movements (McKenzie assessment) has high sensitivity and specificity for nerve root pain associated with symptomatic discs.…”

Section: Femoroacetabular Joint Derangement (Ie Osteoarthritismentioning

confidence: 99%

Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin: A Narrative Literature Review of History, Physical Examination, and Diagnostic Imaging

Battaglia

D’Angelo

Kettner

2016

Journal of Chiropractic Medicine

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Objective: The purpose of this study was to present a narrative review of the literature of musculoskeletal causes of adult hip pain, with special attention to history, physical examination, and diagnostic imaging. Methods: A narrative review of the English medical literature was performed by using the search terms "hip pain" AND "anterior," "lateral," and "posterior." Additionally, specific entities of hip pain or pain referral sources to the hip were searched for. We used the PubMed search engine through January 15, 2016. Results: Musculoskeletal sources of adult hip pain can be divided into posterior, lateral, and anterior categories. For posterior hip pain, select considerations include lumbar spine and femoroacetabular joint referral, sacroiliac joint pathology, piriformis syndrome, and proximal hamstring tendinopathy. Gluteal tendinopathy and iliotibial band thickening are the most common causes of lateral hip pain. Anterior hip pain is further divided into causes that are intra-articular (ie, labral tear, osteoarthritis, osteonecrosis) and extra-articular (ie, snapping hip and inguinal disruption [athletic pubalgia]). Entrapment neuropathies and myofascial pain should also be considered in each compartment. A limited number of historical features and physical examination tests for evaluation of adult hip pain are supported by the literature and are discussed in this article. Depending on the clinical differential, the gamut of diagnostic imaging modalities recommended for accurate diagnosis include plain film radiography, computed tomography, magnetic resonance imaging, skeletal scintigraphy, and ultrasonography. Conclusions: The evaluation of adult hip pain is challenging. Clinicians should consider posterior, lateral, and anterior sources of pain while keeping in mind that these may overlap. (J Chiropr Med 2016;15:281-293)

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“…Theories of pain generation include ligamentous or capsular tension, extraneous compression or shear forces, hypomobility or hypermobility, aberrant joint mechanics, and imbalances in the myofascial or kinetic chain that result in inflammation and pain [14]. Intra-articular sources of SIJ pain include osteoarthritis; extra-articular sources include enthesis/ligamentous sprain and primary enthesopathy.…”

Section: Pathophysiologymentioning

confidence: 99%

“…Open surgical access for SIJ arthrodesis can be achieved anteriorly or posteriorly, although the anterior approach has several advantages in that it provides direct exposure of the ventral and cranial synovial portion of the sacroiliac complex without sacrificing any of the primary soft tissue (ligamentous) stabilizers [14]. The incidence of significant complications after open SIJ fusion has been reported to be between 6 and 25 % [74,75].…”

Section: Surgical Treatmentmentioning

confidence: 99%

Sacroiliac joint pain after lumbar/lumbosacral fusion: current knowledge

Yoshihara

2012

Eur Spine J

110

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Recently, the sacroiliac joint (SIJ) has gained increased attention as a source of persistent or new pain after lumbar/lumbosacral fusion. The underlying pathophysiology of SIJ pain may be increased mechanical load, iliac crest bone grafting, or a misdiagnosis of SIJ syndrome. Imaging studies show more frequent degeneration of the SIJ in patients with lumbar/lumbosacral fusion than in patients without such fusion. Using injection tests, it has been shown that SIJ pain is the cause of persistent symptoms in a considerable number of patients after fusion surgery. Recent articles reporting on surgical outcomes of SIJ fusion include a high percentage of patients who had lumbar/lumbosacral fusion or surgery before, although well-controlled clinical studies are necessary to assess the efficacy of surgical treatment. Taking these findings into consideration, the possibility that the SIJ is the source of pain should be considered in patients with failed back surgery syndrome after lumbar/lumbosacral fusion.

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Sacroiliac Joint Pain

Cited by 254 publications

References 30 publications

Documentation of outcomes for sacroiliac joint fusion: does prior spinal fusion influence the outcome?

Documentation of outcomes for sacroiliac joint fusion: does prior spinal fusion influence the outcome?

Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin: A Narrative Literature Review of History, Physical Examination, and Diagnostic Imaging

Sacroiliac joint pain after lumbar/lumbosacral fusion: current knowledge

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