Sacroiliac joint dysfunction: pathophysiology, diagnosis, and treatment

Area of Science:

• Orthopedics
• Rheumatology
• Pain Management

Background:

• The sacroiliac joint (SIJ) is vital for spinal mobility, stability, and resisting shear forces.
• Age-related changes can limit SIJ mobility, contributing to pain and dysfunction.
• SIJ dysfunction is an under-recognized cause of low back pain, stemming from various clinical conditions or joint malalignment.

Purpose of the Study:

• To comprehensively review the anatomy, function, and pathophysiology of the SIJ.
• To outline the clinical presentation, diagnostic criteria, and treatment strategies for SIJ dysfunction.

Main Methods:

• A literature review was conducted to gather information on SIJ anatomy, etiology, risk factors, diagnostic modalities, and treatment options.
• Diagnostic evaluation involves physical maneuvers and image-guided anesthetic injections.
• Evidence level is I, based on individual cross-sectional studies with a consistently applied reference standard and blinding.

Main Results:

• SIJ dysfunction can arise from diverse clinical conditions and abnormal joint motion or alignment.
• Diagnosing SIJ dysfunction is challenging, often relying on physical examination and anesthetic blocks.
• Non-operative treatments, including conservative management, radiofrequency treatment, nerve blocks, and articular injections, are preferred first-line options due to surgical complication rates.

Conclusions:

• SIJ dysfunction is increasingly prevalent, particularly in an aging population.
• Further research into SIJ pathophysiology and risk factors is essential for developing effective prevention and treatment strategies.
• Improved diagnostic methods are critical for timely intervention and patient recovery, with treatment options ranging from conservative care to surgical fixation.