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Assessing the Accuracy of Ultrasound-Guided Needle Placement in Sacroiliac Joint Injections
Arthur Jason De Luigi1, Vikramjeet Saini, Rajat Mathur
1From the Mayo Clinic Arizona, Mayo Clinic School of Medicine, MedStar National Rehabilitation Hospital, MedStar Georgetown University Hospital, Georgetown University School of Medicine, Washington, DC (AJDL); MedStar National Rehabilitation Hospital, Phoenix Neurological & Pain Institute, Chandler, Arizona (VS); MedStar National Rehabilitation Network, Washington, DC (RM); Brandon Regional Hospital, Brandon, Florida (AS); and MedStar National Rehabilitation Hospital, Regenerative Orthopedics and Sports Medicine, Washington, DC (NY).
Objective:
The aim of the study was to assess the accuracy of ultrasound-guided needle placement for sacroiliac joint injections.
Design:
Institutional review board approval was gained for a prospective cohort study of 50 patients (N = 50). Study patients who were referred for sacroiliac joint injections for sacroiliac joint mediate pain and met inclusion/exclusion criteria were enrolled in the study. Each patient underwent needle placement with ultrasound guidance in the procedure suite. After the needle was placed with the ultrasound guidance, fluoroscopy was used to confirm correct placement via contrast injection confirming a sacroiliac joint arthrogram. The arthrogram was confirmed via the performing physician and radiologist.
Results:
The placement of the needle with ultrasound guidance into the sacroiliac joint was confirmed successful in 96% (48/50) patients by fluoroscopic arthrogram. The two patients with unsuccessful arthrograms after initial placement of the needle with ultrasound were morbidly obese. There was intravascular uptake during the arthrogram of one patient who had a successful arthrogram.
Conclusions:
Ultrasound-guided injection of the sacroiliac joint is successful and accurate upon confirmation of fluoroscopic arthrogram and should be used as an imaging modality for needle guidance.
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