Review of Sacroiliac Joint Injection Techniques

Area of Science:

• Pain Management
• Interventional Radiology
• Musculoskeletal Imaging

Background:

• Sacroiliac joint (SIJ) injections are a common procedure for diagnosing and treating SIJ-mediated pain.
• Various imaging guidance techniques are employed, each with potential differences in accuracy and effectiveness.

Purpose of the Study:

• To evaluate the current evidence comparing the accuracy of different guidance techniques for SIJ injections.
• To assess the impact of guidance technique on procedural success and patient outcomes.

Main Methods:

• A systematic literature search was conducted for retrospective, prospective, and randomized controlled studies.
• Studies involving ultrasound, fluoroscopy, and CT guidance for SIJ injections were included.
• Eight studies with a total of 420 patients met the inclusion criteria.

Main Results:

• Computed tomography (CT) guidance demonstrated the highest accuracy in needle placement.
• Fluoroscopy was more accurate than ultrasound guidance.
• Landmark-guided injections showed poor accuracy.
• Accurate needle placement confirmed SIJ-mediated pain, and corticosteroid injections improved outcomes regardless of guidance.

Conclusions:

• CT guidance is the most accurate technique for SIJ injections, followed by fluoroscopy and ultrasound.
• Accurate SIJ injection is crucial for confirming pain origin and achieving therapeutic benefits.
• Diagnostic CT-guided SIJ injections are recommended before considering SIJ fusion.