Fluoroscopy-guided Sacroiliac Joint Steroid Injection for Low Back Pain in a Patient with Osteogenesis Imperfecta

Area of Science:

• Medical Case Study
• Pain Management
• Rheumatology

Background:

• Osteogenesis imperfecta (OI), or brittle bone disease, is a genetic disorder causing bone fragility and low bone density.
• A 57-year-old female with OI presented with severe low back pain, clinically suspected to originate from the sacroiliac joint.
• Standard X-rays did not reveal sacroiliac joint abnormalities, necessitating further investigation.

Purpose of the Study:

• To evaluate the efficacy of fluoroscopy-guided sacroiliac joint steroid injection for managing low back pain in a patient with osteogenesis imperfecta.
• To assess pain reduction and functional improvement using validated outcome measures.

Main Methods:

• The patient underwent a fluoroscopy-guided left sacroiliac joint steroid injection.
• Pain was assessed using the Numeric Rating Scale (NRS) and functional status via the Oswestry Disability Index (ODI).
• Outcomes were measured at baseline, one week, and eight weeks post-injection.

Main Results:

• The NRS pain score decreased from 6/10 to 0/10 immediately after the procedure.
• The ODI score improved from 40% (moderate disability) to 13% (minimal disability) at one week.
• At eight weeks, pain remained 0/10 (NRS) and disability was minimal at 15% (ODI).

Conclusions:

• Fluoroscopy-guided sacroiliac joint steroid injection is an effective diagnostic and therapeutic tool for sacroiliac joint pain.
• This case represents the first reported instance of using this minimally invasive procedure to treat sacroiliac joint-mediated low back pain in an osteogenesis imperfecta patient.
• The findings suggest this intervention can significantly improve pain and function in OI patients with this specific type of back pain.