[Sacroiliac joint pain - diagnostic algorithm and therapeutic approaches]

The sacroiliac joints are causative for 13-30% of cases with low back pain and are still disregarded in the differential diagnosis. This is mainly due to its complex anatomy and the variety of pain patterns originating from the SI joints. The broad etiology of low back pain often misleads the physician into inadequate treatments. This article reviews the clinical presentation of patients suffering from a sacroiliac arthropathy and points out therapeutic strategies. It also provides a helpful diagnostic tool in daily routine. Eventually, any patient needs to experience a significant pain reduction resulting from an intrarticular injection before the diagnosis of non-inflammatory SI arthropathy is confirmed. In most cases, nonoperative treatment measures are sufficient. Operative strategies are available in selected cases with unsuccessful conservative therapy.