Abstract
Objective
To compare the short-term effects and safety of ultrasound (US)-guided sacroiliac
joint (SIJ) injections with fluoroscopy (FL)-guided SIJ injections in patients with
noninflammatory SIJ dysfunction.
Design
Prospective, randomized controlled trial.
Setting
University hospital.
Participants
Patients (N=120) with noninflammatory sacroiliac arthritis were enrolled.
Intervention
All procedures were performed using an FL or US apparatus. Subjects were randomly
assigned to either the FL or US group. Immediately after the SIJ injections, fluoroscopy
was applied to verify the correct placement of the injected medication and intravascular
injections.
Main Outcome Measures
Treatment effects and functional improvement were compared at 2 and 12 weeks after
the procedures.
Results
The verbal numeric pain scale and Oswestry Disability Index improved at 2 and 12 weeks
after the injections without statistical significances between groups. Of 55 US-guided
injections, 48 (87.3%) were successful and 7 (12.7%) were missed. The FL-guided SIJ
approach exhibited a greater accuracy (98.2%) than the US-guided approach. Vascularization
around the SIJ was seen in 34 of 55 patients. Among the 34 patients, 7 had vascularization
inside the joint, 23 had vascularization around the joint, and 4 had vascularization
both inside and around the joint. Three cases of intravascular injections occurred
in the FL group.
Conclusions
The US-guided approach may facilitate the identification and avoidance of the critical
vessels around or within the SIJ. Function and pain relief significantly improved
in both groups without significant differences between groups. The US-guided approach
was shown to be as effective as the FL-guided approach in treatment effects. However,
diagnostic application in the SIJ may be limited because of the significantly lower
accuracy rate (87.3%).
Keywords
List of abbreviations:
CT (computed tomography), FL (fluoroscopy), IA (intra-articular), ODI (Oswestry Disability Index), SIJ (sacroiliac joint), US (ultrasound), VNS (verbal numeric pain scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 11, 2013
Footnotes
Supported by a 2013 research grant from Inje University, Gimhae, Korea.
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
