[Sacroiliac joint pain - diagnostic algorithm and therapeutic approaches]
Christoph J Laux1, Georg Osterhoff1, Clément M L Werner1
1Klinik für Unfallchirurgie, Universitätsspital Zürich.
Praxis
|January 2, 2015
Summary
Sacroiliac joint pain causes 13-30% of low back pain but is often overlooked. Diagnosis requires pain relief from injections, with nonoperative treatments usually sufficient for sacroiliac arthropathy.
Area of Science:
- Orthopedics
- Rheumatology
- Pain Medicine
Context:
- Sacroiliac (SI) joint dysfunction is a significant, yet often underdiagnosed, cause of low back pain, accounting for 13-30% of cases.
- The complex anatomy and varied pain presentations of the SI joints contribute to diagnostic challenges and potential treatment delays.
- Physicians may be misled by the broad etiology of low back pain, leading to inadequate management strategies.
Purpose:
- To review the clinical presentation of sacroiliac arthropathy.
- To outline diagnostic strategies and therapeutic interventions for SI joint pain.
- To provide a practical diagnostic tool for routine clinical use.
Summary:
- This review details the clinical manifestations of sacroiliac arthropathy, emphasizing its role in low back pain.
- It highlights diagnostic criteria, including the necessity of pain reduction via intra-articular injection for confirming non-inflammatory SI arthropathy.
- The article discusses both nonoperative and operative treatment modalities, favoring conservative approaches when effective.
Impact:
- Improved recognition and diagnosis of sacroiliac joint as a pain generator.
- Guidance on effective diagnostic and therapeutic pathways for clinicians managing low back pain.
- Potential for reduced patient morbidity through timely and appropriate treatment of SI joint dysfunction.
