sacroiliac joint

Due to the complex anatomy of the sacroiliac joint, the success rate of accurate intra-articular injection is only 12 - 22%. Therefore, an imaging guidance tool is strongly recommended. To compare the safety and the short-term efficacy of US and FL-guided SIJ injections in patients with chronic low back pain.

Eligible participants received 40 mg of prednisolone plus Marcaine. The two groups were compared based on NRS at four measurement point times (T0-T3): Baseline, 15 min, 60 min, and 24 hours after the procedure. The number of punctures, the time of the procedure, and any adverse effects were also documented and compared between the two groups. Statistical analysis was done using SPSS version 21 with a significant level of less than 0.05.

Seventy-six eligible cases were enrolled in the survey and randomly divided into ultrasound (US) and fluoroscopy (FL) groups. In both groups, NRS significantly decreased from baseline to 24 hours after the procedures (P = 0.001). However, no significant difference was observed. In four measurement point times, except for 60 minutes after the procedure, the NRS score was significantly lower in group FL. The number of punctures was not significantly different. However, comparing the two groups, the procedure time was considerably shorter in the US group (P = 0.001). None of our patients reported any adverse effects related to the procedures.

The US and FL could be accepted as proper guidance tools, while the intervention time was shorter in the US group.

Sacroiliac joint (SIJ) pain poses a significant burden on patients and the healthcare system. Due to its potential for tissue regeneration, minimally invasive administration, and affordability, platelet-rich plasma (PRP) has recently gained attention in the management of SIJ pain. Although PRP is widely used for musculoskeletal conditions, there is limited evidence regarding its application in SIJ pain.

This study aims to assess the impact of PRP injections in patients with chronic SIJ pain that is unresponsive to conservative treatments.

This study is a single-arm, open-label clinical trial. Patients aged between 30 and 80 years with chronic SIJ pain were included. Platelet-rich plasma was prepared from autologous blood and injected into the SIJ under ultrasound (US) guidance. Pain intensity was assessed using the Numeric Rating Scale (NRS), and functional disability was measured using the Modified Oswestry Disability Index (MODI) before the intervention, as well as one month and three months post-injection. Statistical analysis was performed using repeated measures ANOVA in SPSS version 23 to evaluate changes over time.

A total of 16 patients were included in the study. At the one-month follow-up, the mean pain intensity dropped to 5.19 ± 2.66, followed by a slight increase to 5.75 ± 2.54 at the three-month follow-up. The mean MODI score was 67.00 ± 8.42 at baseline, improving to 46.75 ± 21.46 at one month, and slightly increasing to 50.50 ± 19.98 at three months. The overall changes in pain intensity and disability index over the three months were statistically significant (P < 0.001). No significant adverse events were reported.

Platelet-rich plasma injection resulted in significant pain reduction and functional improvement for chronic SIJ pain over three months, suggesting its potential as a minimally invasive therapeutic alternative for patients who are unresponsive to conventional therapies. While PRP appears to be a safe modality for SIJ pain management, further studies with larger sample sizes and extended follow-ups are needed to explore its effectiveness and safety.

 Incidental findings in imaging are defined as findings that appear accidentally in radiological images, and usually, the patient does not have a complaint related to the desired finding. These findings range from no-risk to high-risk. This study aimed to evaluate the prevalence of incidental findings of gynecological diseases in hip and sacroiliac Magnetic Resonance Imaging (MRI) in Imam Hossein Hospital in 2022.

 In this cross-sectional descriptive study, all patients referred to Imam Hossein Hospital (Iran-Tehran) during one year (2022) who underwent hip and sacroiliac MRI were evaluated. Hip and sacroiliac MRI images were reviewed. The following pathological findings were recorded: pelvic vascular congestion, ovarian cyst, myoma, and ovarian masses. Patients' information about age and underlying disease were also extracted from patients' files. Hip and sacroiliac diseases were also recorded. Finally, all recorded data were analyzed using the SPSS program.

 Hip and sacroiliac MRI of 364 female patients were assessed. The mean age of the patients was 50.18±13.46 years. Discopathy was the most prevalent finding in the MRI (41.76%) as a pathological finding. The prevalence of incidental findings was 32.3%. The most common incidental finding in MRI was free fluid with a prevalence of 12.1%, and ovarian cyst was seen in 6.3% of patients. There was a significant relationship between most of the incidental findings and age (P-values<0.05).

 The prevalence of incidental findings of gynecological diseases in women undergoing hip and sacroiliac MRI is considerable and shows the importance of the radiologist’s attention to review and report the entire MRI images.

Sacroiliac pain is one of the causes of low back pain, representing with discomfort and tenderness in the sacroiliac joint. Interventional procedures might be beneficial in cases unresponsive to medical treatments. Here, we aimed to investigate the effects of intra‑articular corticosteroid injections in patients with sacroiliac pain.

This is a clinical trial performed in 2017–2018 in Kashani Hospital, Isfahan, on patients with low back pain and formerly diagnosed with sacroiliac pain. Patients were recruited based on inclusion and exclusion criteria. Corticosteroid injections were performed for patients. Patients were visited within 2 weeks, 4 weeks, and 6 months after interventions, and pain and disabilities of patients were assessed using the numerical rating scale (NRS) and Oswestry Disability Questionnaire.

A total number of 27 patients entered our clinical trial. We showed that the mean NRS score among patients before interventions was 8.01 ± 0.96. Assessments of disability score also indicated that the mean disability scores was 41.48 ± 7.48. Our data also indicated that there was a significant reducing trend in both NRS and disability score after interventions (P < 0.001 for both items).

Intra‑articular steroid injection is associated with significantly reduced pain and disability in patients with sacroiliac pain. Previous studies evaluated variable methods and reported that this method has high values and significant advantages compared with other techniques which were in line with our results.

 Vast majority of the muscular disorders are known to be related to Sacroiliac joint. Due to the main role played by Sacroiliac joint, the current study was conducted to examine the effect of the pain among the people suffering from Sacroiliac joint pain on the vertical ground reaction force parameter. 

 This case control study was carried out on 19 participants with Sacroiliac joint pain, VAS 3-5 and average age of 27±5.7, and 19 subjects with normal health conditions and average age of 29±7.6. The relevant data were collected while the participants were asked to walk at their desired speed over the force plate located on their way. Later on, all the parameters of vertical ground reaction force in the stance phase were recorded. At the end, data collected were compared by independent T-test in SPSS. 

 The results of the study revealed that participants distributed in control (healthy individuals) and experimental (individuals with Sacroiliac joint pain) groups were significantly different regarding the parameters of time and speed required to reach the stage of weight transition to the heel. 

 Considering the findings, it can be concluded that some compensatory strategies were adopted by the individuals with Sacroiliac joint- related problems in order to decrease the force that body experienced during walking.

Lumbar stiffness is a common complaint of patients with low back pain. The Muscle Energy Technique (MET) is a common intervention to treat the spine and sacroiliac joint dysfunctions and their resulting disability in daily activities. This research aimed to evaluate the effects of MET on pain, functional disability, and lumbar stiffness of patients with sacroiliac joint dysfunctions by considering the type of dysfunction and the orientation of the correcting maneuver.

Fifty women with ant innominate or post innominate dysfunctions were recruited for the research and randomly divided into two groups (n=25). One group received one session of MET, and the other group received the sham position. Visual Analogue Scale (VAS), lumbar Stiffness Disability Index (SDI) and Oswestry Disability Index (ODI) were used for the evaluation of the participants before, 24 hours after and one week after the intervention.

According to the results, MET significantly decreased the mean range of VAS and ODI, 24 hours, and a week after the intervention (P<0.01). We did not see any significant difference in SDI values before, 24 hours, and one week after MET in the patients (P>0.01).

Applying MET regarding the kind of dysfunction may reduce the patient’s pain and disability.