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Success Rate of Intra-articular Sacroiliac Joint Injection: Fluoroscopy vs Ultrasound Guidance-A Cadaveric Study
Wolfgang Stelzer1, Dominik Stelzer1, Elisabeth Stelzer1
1Schmerzlos Zentrum, Linz, Austria.
Pain Medicine (Malden, Mass.)
|April 7, 2019
Summary
Fluoroscopy demonstrated a higher success rate for sacroiliac joint injections compared to ultrasound guidance. This study assessed image-guided injection accuracy using cadaver dissection to improve patient outcomes.
Area of Science:
- Orthopedics
- Radiology
- Anatomy
Background:
- Non-image-guided sacroiliac joint injections have high miss rates.
- Fluoroscopy and ultrasound are recommended for guidance.
- Cadaver dissection was used to assess the real success rate of both techniques.
Purpose of the Study:
- To compare the accuracy of fluoroscopy versus ultrasound guidance for sacroiliac joint injections.
- To evaluate needle placement and injectate spread using cadaveric specimens.
Main Methods:
- Twenty donated bodies (40 sacroiliac joints) were used.
- Fluoroscopy and ultrasound guidance were performed on separate sets of 10 bodies each.
- Injections were followed by dissection to assess intra-articular spread.
Main Results:
- Fluoroscopy achieved a 50% intra-articular injection rate, with 85% of practitioners having a subjective sense of correct placement.
- Ultrasound guidance resulted in only 5% intra-articular injections, with 50% subjective accuracy.
- Latex spread in the interosseous sacroiliac ligament occurred in 95% of ultrasound-guided cases.
Conclusions:
- Fluoroscopy demonstrated a significantly higher success rate for intra-articular sacroiliac joint injections.
- Image guidance is crucial for accurate sacroiliac joint injections, with fluoroscopy showing superior performance in this study.
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