Ultrasound-guided sacroiliac joint injection

Czech version

Authors: K. Mezian ¹; K. Sobotová ²; T. Novotný ³; J. Vacek ⁴; Š. Kozák ⁵; O. Naňka ⁶
Authors‘ workplace: Klinika rehabilitačního lékařství 1. LF UK a VFN v Praze ¹; Klinika rehabilitace a tělovýchovného lékařství 2. LF UK a FN Motol, Praha ²; Ortopedická klinika Fakulty zdravotnických studií Univerzity J. E. Purkyně v Ústí nad Labem a Krajské zdravotní a. s. – Masarykovy nemocnice v Ústí nad Labem, o. z. ³; IPVZ, Praha ⁴; Klinika anesteziologie a resuscitace 3. LF UK a FN Královské Vinohrady, Praha ⁵; Anatomický ústav 1. LF UK, Praha ⁶
Published in: Cesk Slov Neurol N 2021; 84(5): 481-485
Category: Short Communication
doi: https://doi.org/10.48095/cccsnn2021481

Overview

In this article, an ultrasound-guided technique for sacroiliac joint (SIJ) injection is described. The SIJ was repeatedly identified as a possible pain generator in patients with low back pain. In cases where other (noninvasive) treatment options fail, SIJ injection might provide pain relief. The described procedure can also be used to perform a diagnostic blockage. In patients refractory to other treatments, the identification of SIJ as the main source of nociception may be important for a possible further procedure (e. g., surgery).

Keywords:

sacroiliac joint – low back pain – ultrasonography – injection

Sources

1. Vagaská E, Andrašina T, Voháňka S et al. Změna struktury paraspinálních svalů u pacientů s chronickými nespecifickými bolestmi dolní části zad. Cesk Slov Neurol N 2019; 82/115 (5): 505–512. doi: 10.14735/amcsnn2019505.

2. Nováková E, Říha M. Vertebrogenní algický syndrom – medicína založená na důkazech a běžná klinická praxe. Existuje důvod něco změnit? Cesk Slov Neurol N 2017; 80/113 (3): 280–284. doi: 10.14735/amcsnn2017280.

3. Gabrhelík T, Adamus M, Pieran M et al. Radiofrekvenční terapie facetových bolestí bederní páteře. Cesk Slov Neurol N 2009; 72/105 (2): 125–131.

4. Mezian K, Steyerová P, Vacek J et al. Úvod do neuromuskulární ultrasonografie. Cesk Slov Neurol N 2016; 79/112 (6): 656–661. doi: 10.14735/amcsnn2016656.

5. Simopoulos TT, Manchikanti L, Gupta S et al. Systematic review of the diagnostic accuracy and therapeutic effectiveness of sacroiliac joint interventions. Pain Physician 2015; 18: E713–E756.

6. Merskey H, Bogduk N. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. Seattle, WA, USA: IASP Press 1994: 190–191.

7. Szadek KM, Hoogland PV, Zuurmond WW et al. Nociceptive nerve fibers in the sacroiliac joint in humans. Reg Anesth Pain Med 2008; 33 (1): 36–43. doi: 10.1016/j.rapm.2007.07.011.

8. Puhakka KB, Melsen F, Jurik AG et al. MR imaging of the normal sacroiliac joint with correlation to histology. Skeletal Radiol 2004; 33 (1): 15–28. doi: 10.1007/s00256-003-0691-4.

9. Foley BS, Buschbacher RM. Sacroiliac joint pain: anatomy, biomechanics, diagnosis, and treatment. Am J Phys Med Rehabil 2006; 85 (12): 997–1006. doi: 10.1097/01.phm.0000247633.68694.c1.

10. Mezian K, Sobotová K, Abdulsalam A et al. Sacroiliac, caudal and coccyx injections, in: ultrasound imaging & guidance for musculoskeletal interventions in physical and rehabilitation medicine. Milan: Edi Ermes 2019.

11. Jee H, Lee JH, Park KD et al. Ultrasound-guided versus fluoroscopy-guided sacroiliac joint intra-articular injections in the noninflammatory sacroiliac joint dysfunction: a prospective, randomized, single-blinded study. Arch Phys Med Rehabil 2014; 95 (2): 330–337. doi: 10.1016/j.apmr.2013.09.021.

12. Soneji N, Bhatia A, Seib R et al. Comparison of fluoroscopy and ultrasound guidance for sacroiliac joint injection in patients with chronic low back pain. Pain Pract 2016; 16 (5): 537–544. doi: 10.1111/papr.12304.

13. De Luigi AJ, Saini V, Mathur R et al. Assessing the accuracy of ultrasound-guided needle placement in sacroiliac joint injections. Am J Phys Med Rehabil 2019; 98 (8): 666–670. doi: 10.1097/PHM.0000000000001167.

14. Perry JM, Colberg RE, Dault SL et al. A Cadaveric study assessing the accuracy of ultrasound-guided sacroiliac joint injections. PM R 2016; 8 (12): 1168–1172. doi: 10.1016/j.pmrj.2016.05.002.

15. Mezian K, Naňka O. Non-fresh formaldehyde-embalmed cadaver: not an eligible model for Ultrasound Guided Sacroiliac Joint Injection studies. Med Ultrason 2017; 19 (4): 457–461. doi: 10.11152/mu-1269.

16. Luukkainen RK, Wennerstrand PV, Kautiainen HH et al. Efficacy of periarticular corticosteroid treatment of the sacroiliac joint in non-spondylarthropathic patients with chronic low back pain in the region of the sacroiliac joint. Clin Exp Rheumatol 2002; 20 (1): 52–54.

17. Vilensky JA, O‘Connor BL, Fortin JD et al. Histologic analysis of neural elements in the human sacroiliac joint. Spine (Phila Pa 1976) 2002; 27 (11): 1202–1207. doi: 10.1097/00007632-200206010-00012.

18. Borowsky CD, Fagen G. Sources of sacroiliac region pain: insights gained from a study comparing standard intra-articular injection with a technique combining intra- and peri-articular injection. Arch Phys Med Rehabil 2008; 89 (11): 2048–2056. doi: 10.1016/j.apmr.2008.06.006.

19. Do KH, Ahn SH, Jones R et al. A new sacroiliac joint injection technique and its short-term effect on chronic sacroiliac region pain. Pain Med 2016; 17 (10): 1809–1813. doi: 10.1093/pm/pnw003.

20. Lodin J, Prochazka J, Jelinek M et al. A systematic review of the clinical efficacy of sacroiliac joint stabilization in the treatment of lower back pain. Cesk Slov Neurol N 2019; 82/115 (6): 655–663. doi: 10.14735/amcsnn 2019655.