Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SACROILIAC JOINT”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Morphologic analysis of bipolar radiofrequency lesions: implications for treatment of the sacroiliac joint.

BACKGROUND AND OBJECTIVES: Sacroiliac (SI) joint dysfunction is an important cause of mechanical low-back pain. Bipolar radiofrequency ablation has been proposed as a long-lasting treatment for pain in patients with SI dysfunction who report temporary pain relief with local-anesthetic injection into the joint. No data are available to guide the technical aspects of bipolar radiofrequency lesion creation. This study documents the optimal spacing of cannulae and time required to produce bipolar lesions by use of radiofrequency technology. METHODS: Two radiofrequency cannulae were secured in a parallel position 2, 4, 6, 8, and 10 mm apart and submerged in egg white for lesion production in a medium that would allow visualization of the size and shape of the lesions as they were created. Temperatures of the probes were raised from 40 degrees C to 90 degrees C at a constant rate and were held at 90 degrees C for 190 seconds. The progress of lesion formation was photographed every 10 seconds, and the resultant surface area of the lesions was measured from the digital images. RESULTS: Contiguous strip lesions were produced when the cannulae were spaced 6 mm or less apart; unipolar lesions around each cannula resulted if they were spaced more than 6 mm apart. Ninety percent of the final lesion area was reached by 120 seconds, and the final lesion size was reached by 150 seconds, regardless of spacing. CONCLUSIONS: Bipolar radiofrequency treatment creates continuous "strip" lesions proportional in size to the distance between the probes when the distance between cannulae is 6 mm or less. Spacing the cannulae 4 to 6 mm apart and treating at 90 degrees C for 120 to 150 seconds maximizes the surface area of the lesion.

Catheter Ablation↗
PubMed1990

Computed tomography of the sacroiliac joints in four patients with Behçet's syndrome--confirmation of sacroiliitis.

In order to reduce the subjective factor in evaluating sacroiliac joint radiographs we further evaluated changes seen on standard plain films of patients suffering from Behçet's syndrome (BS) by using computed tomography (CT). Sacroiliac joint films of 20 consecutive patients with BS were mixed with those of 20 consecutive control patients and read blindly and independently by two observers. Six patients with BS met the New York criteria for sacroiliitis. Of the control patients, one had monolateral grade 1 sacroiliitis and two revealed findings consistent with osteitis condensans ilii. CT confirmed the diagnosis of sacroiliitis in patients with BS showing a high degree in at least one joint. The results of the present study suggest that the use of CT for BS patients showing sacroiliac joint changes on pelvic plain films may limit the confusion which exists about this finding in BS.

Adult↗
PubMedDate not supplied

The functional topography of the sacroiliac joint.

This work analyzes the motion permitted by the topography of the sacroiliac joint surface. Gross contour profiles of the joint were recorded in the frontal and sagittal planes. Best-fit axes of rotation for each contour profile were obtained by statistical methods and were compared with those reported in the literature. There was considerable scatter of the locations of the most likely centers, or axes, of rotation in the frontal and sagittal planes. Were motion to occur about these axes, the articular surfaces would first separate by a distance sufficient to allow them to move over one another. Energy would be needed to separate the joint surfaces being pulled together by the surrounding ligaments. Thus, the sacroiliac joint may function as a shock- absorbing structure by virtue of energy absorbed in the ligamentous tissue.

Female↗
PubMed2002

CT-guided percutaneous radiofrequency denervation of the sacroiliac joint.

Defining the origin of low back pain is a challenging task. Among a variety of factors the sacroiliac joint (SIJ) is a possible pain generator, although precise diagnosis is difficult. Joint blocks may reduce pain, but are, in cases, of only temporary effect. This study was conducted to evaluate CT-guided percutaneous radiofrequency denervation of the sacroiliac joint in patients with low back pain. The procedure was performed on 38 patients who only temporarily responded to CT-guided SIJ blocks. The denervation was carried out in the posterior interosseous sacroiliac ligaments and on the dorsal rami of the fifth spinal nerve. All interventions were carried out under CT guidance as out-patient therapies. Three months after the therapy, 13 patients (34.2%) were completely free of pain. Twelve patients (31.6%) reported on a substantial pain reduction, 7 patients (18.4%) had obtained a slight and 3 patients (7.9%) no pain reduction. The data of 3 patients (7.9%) was missing. There were no intra- or postoperative complications. Computed tomography-guided percutaneous radiofrequency denervation of the sacroiliac joint appears safe and effective. The procedure may be a useful therapeutic modality, especially in patients with chronic low back pain, who only temporarily respond to therapeutic blocks.

Adult↗
PubMed2005

Spondyloarthritis research Consortium of Canada magnetic resonance imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis.

OBJECTIVE: To develop a feasible magnetic resonance imaging (MRI)-based scoring system for sacroiliac joint inflammation in patients with ankylosing spondylitis (AS) that requires minimal scan time, does not require contrast enhancement, evaluates lesions separately at each articular surface, and limits the number of sacroiliac images that are scored. METHODS: A scoring method based on the assessment of increased signal denoting bone marrow edema on T2-weighted STIR sequences was used. MRI films were assessed blindly in random order at 2 sites by multiple readers. Intra- and interreader reliability was assessed by intraclass correlation coefficient (ICC); the 24-week response of patients with AS randomized to placebo:infliximab (3:8) was assessed by effect size and standardized response mean. The reliability and responsiveness of the scoring method were compared for STIR and gadolinium diethylenetriaminepentaacetic (Gd-DTPA)-enhanced MRI sequences. RESULTS: We scanned 11 patients with AS with clinically active disease and 11 additional patients randomized to the trial of infliximab therapy. ICC for total sacroiliac joint STIR score ranged from 0.90 to 0.98 (P < 0.00001) and interobserver ICC for combined readers from the 2 sites was 0.84 (P < 0.0001). ICC for change scores was lower for STIR (ICC 0.53) than for Gd-DTPA-enhanced sequences (ICC 0.79). Responsiveness was poor, although fusion was evident in one-third of patients who received treatment (placebo:infliximab) and inflammation scores were low. CONCLUSION: The Spondyloarthritis Research Consortium of Canada MRI index is a feasible and reproducible index for measuring sacroiliac joint inflammation in patients with AS.

Adult↗
PubMed1985

[Morphological study of the sacroiliac joint of aged Japanese and macroscopic and microscopic observations on its articular surface].

Little information has so far been obtained in anatomical investigation of the sacroiliac joint. The purpose of this study was to investigate the sacroiliac joints morphologically and pathologically for the purpose of revealing the cause of low back pain. The materials consisted of 24 cadavers with both sides of the sacroiliac joint present. Firstly, investigation was performed radiographically to determine the shape and slope of the joint at the anatomical position. Secondly, measurement of the articular surfaces on photographs was performed to show the average of various measurements e.g. area, circumference, length, width etc., further more the differences between sacral and iliac articular surfaces and that of sex were demonstrated. Next, macroscopic and microscopic investigations of the joint cartilage were were performed. In general, degenerative changes were seen in all specimens and marked changes were found on the middle-anterior part of the joint.

Aged↗
PubMed1996

The sacroiliac joint in the spondyloarthropathies.

The term spondyloarthropathy (SpA) describes and defines a group of related inflammatory joint disease that share characteristic clinical features and a unique association with the major histocompatibility complex class I molecule HLA-B27. Five subgroups can be differentiated: ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease, and undifferentiated SpA. The sacroiliac joints are centrally involved in the SpA, most clearly and pathognomonic in ankylosing spondylitis, in which most patients are affected early in the disease. Overcoming some of the diagnostic difficulties of early sacroiliitis, dynamic magnetic resonance imaging was shown to visualize both acute and chronic changes in the sacroiliac joints. The inflammation in the sacroiliac joints in patients with SpA was recently examined in more detail; using immunohistology and in situ hybridrization, T cells, macrophages, and various cytokines were found in infiltrates. Biopsy specimens were obtained under guided computed tomography, and in the same study, intra-articular corticosteroid treatment was successfully undertaken. Further investigation of such biopsy specimens showed the absence of DNA of reactive arthritis-associated bacteria. The pathogenesis of the SpA and the reason for the tropism for the sacroiliac joints is still obscure. The nature of the relation of the genetic background of SpA to initially triggering bacterial infections remains to be established. In chronic disease, autoimmune mechanisms might be more important.

Humans↗
PubMedDate not supplied

[Innervation of the sacroiliac joint of the human].

The innervation of the human sacroiliacal joint was investigated on adult cadaveric specimens devoted for routine dissection courses, and on fetuses obtained from therapeutic abortions. Gross anatomical and microscopic dissection, histology of dissected nerves, and histological and immunocytochemical approaches were used. Innervation of the iliosacral joint is provided by fine nerve branches derived exclusively from dorsal rami of spinal nerves S1-S4. No branches could be detected from the plexus sacralis and obturator nerve coursing over the ventral aspect of the joint. Nerves were distributed to superficial and deep dorsal sacroiliac ligaments, and to the sacrotuberous and sacrospinous ligaments. Dorsal spinal rami continued their course laterally, sandwiched between superficial and deep portions of sacroiliac ligaments, piercing the origin of the glutaeus maximus muscle. Histological examination of dissected nerves demonstrated numerous thick myelinated, besides thin myelinated and unmyelinated nerve fibers compatible with a broad repertoire of sensory receptors including encapsulated mechanoreceptors. Histological and immunocytochemical studies on fetal iliosacral joints showed neurofilament positive nerve fibers only in dorsal portions. This innervation pattern may provide explanations for various patterns of pseudoradicular and referred pain in affections of the sacroiliac joint.

Adult↗
PubMed1995

Recurrent subluxation of the sacroiliac joint: diagnosis and treatment.

A review of the clinical evidence of the sacroiliac joint as a source of pain, impairment, and disability is presented along with the concept of recurrent subluxation and discussion of the various treatment options for managing this problem emphasizing sacroiliac stabilization with screws. The surgical results for 15 patients with isolated sacroiliac joint dysfunction and an 11 patients with a combination of sacroiliac dysfunction and lumbar spine problems are presented. The surgical results indicate that sacroiliac fixation is a simple, safe, and highly effective means of managing this condition.

Adult↗
PubMed1988

Abnormalities of the sacroiliac joints in diffuse idiopathic skeletal hyperostosis: demonstration by computed tomography.

Eight patients with classical spinal radiographic features of diffuse idiopathic skeletal hyperostosis (DISH) had pelvic radiographs which suggested sacroiliac joint abnormalities. No patient had clinical features of ankylosing spondylitis. Computed tomography of the sacroiliac joints revealed several abnormalities including asymmetric intraarticular partial fusion, osteophytes with or without bridging, and vacuum phenomenon. Sacroiliac joint disease can complicate DISH.

Aged↗
PubMed2002

The aging process in the sacroiliac joint: helical computed tomography analysis.

The purpose of this study was to compare the frequency of degenerative changes in the sacroiliac joint by age, sex, laterality, body mass index, and childbearing experience, based on computed tomography (CT) images obtained from the lower back of symptom-free subjects in different age groups. These data were used to trace the development of the sacroiliac joint until the occurrence of osteoarthritis with aging. CT transverse and coronal images were examined for the presence of the following degenerative signs: joint space narrowing, sclerosis, osteophytes, cysts, and erosion. The results indicated that joint degeneration begins in the 20s and tends to progress with age. Each form of degeneration was markedly more frequent in the 40s or older, and some type of degeneration was observed in the joints of all subjects aged 50 years or older. In terms of the localization of the joint degeneration, sclerosis was common on the upper and middle anterior of the articular surface of the ilium, and osteophytes were common on the anterior surface of the sacrum. Degeneration had progressed further in women than in men in every age group, and tended to progress faster in parous than in nulliparous women. It was presumed that the birth of the first child, rather than subsequent births had the greatest effect on the sacroiliac joint.

Adult↗
PubMed2003

Sacroiliac joint injections performed with sonographic guidance.

OBJECTIVE: To investigate the feasibility and effectiveness of sonographic guidance for therapeutic intra-articular sacroiliac joint injections in patients with sacroiliitis. METHODS: Thirty-four consecutive patients with sacroiliitis were enrolled in this study. The synovial portions of 60 sacroiliac joints received injections under sonographic guidance. For treatment, a mixture of a corticosteroid and a local anesthetic was injected intra-articularly. Fluoroscopic spot images were obtained to assess the accuracy of the sonographically guided technique. RESULTS: Of the 60 sonographically guided injections, 46 (76.7%) were successful (i.e., intra-articular), and 14 (23.3%) were missed. The successful intra-articular injection rate was 60% in the first 30 injections, and it gradually improved, reaching 93.5% in the last 30 injections. The mean procedure time was 9 minutes. CONCLUSIONS: Our initial experience suggests that sonographically guided therapeutic injections to sacroiliac joints could be valuable alternatives to other guidance modalities in patients with sacroiliitis. In the hands of experienced radiologists, this technique is safe, rapid, and reproducible.

Adrenal Cortex Hormones↗
PubMed1987

The prevalence of osteoarthrosis of the sacroiliac joints in an urban population.

Little attention has been paid to the sacroiliac joints especially with respect to the occurrence of degenerative changes. Two hundred thirty nine of the 1200 persons with rheumatic complaints were examined. In 186 of them osteoarthritis of the sacroiliac joints was found (78%). Among test subjects 51.6% suffered from the low back pain.

Adult↗
PubMedDate not supplied

The early diagnosis of sacroiliac joint infections in children.

UNLABELLED: We retrospectively reviewed the medical records and imaging studies of 15 children with infections of the sacroiliac joint to determine the usefulness of specific examinations and studies to aid in the early diagnosis of this condition. The clinical presentation, physical examination findings, pertinent laboratory data, and imaging studies were reviewed. Thirteen patients (87%) were febrile at the time of presentation. One patient presented in septic shock requiring intubation and critical care management. Tenderness to palpation over the sacroiliac joint was present in all 9 patients who had this examination performed, and the flexion abduction external rotation test was positive in 10 of 12 patients (83%) who had this test done. Laboratory indicators of infection were elevated in most patients, and 6 patients (46%) had positive blood cultures, most commonly growing Staphylococcus aureus. Initial conventional radiographs were negative in all but 1 patient. Radionuclide 99-m-technetium bone scans were positive in 7 of 10 patients (70%), and magnetic resonance imaging studies were ultimately positive in 13 of 14 patients (93%). However, within the first 6 days after the onset of symptoms, only 5 of 8 bone scans (63%) and 5 of 9 magnetic resonance imaging studies (57%) were consistent with infection. We conclude that while diagnostic imaging studies are ultimately helpful in confirming the diagnosis of sacroiliac joint infections in children, studies made within 6 days of the onset of symptoms may not always confirm the diagnosis. The early diagnosis of this condition is best made on the basis of clinical and laboratory findings. LEVEL OF EVIDENCE: Therapeutic Study, level IV (Case series [no, or historical control group]).

Adolescent↗
PubMed2000

A radiostereometric analysis of the movements of the sacroiliac joints in the reciprocal straddle position.

STUDY DESIGN: A Radiostereometric analysis of the reciprocal straddle position. OBJECTIVES: To evaluate the magnitude of rotation in the sacroiliac joints in the reciprocal straddle position. SUMMARY OF BACKGROUND DATA: The reciprocal straddle position has been objectified in different studies, using different techniques, to show a sacroiliac motion between 5 degrees and 36 degrees. Previous studies with radiostereometric analysis during different provocations reported much smaller movements. METHODS: Six women with posterior pelvic pain of long duration after pregnancy (n = 5) and sacroiliitis (n = 1) underwent radiostereometric analysis in the sustained reciprocal straddle position. RESULTS: A reciprocal movement could be demonstrated in the sacroiliac joints in the reciprocal straddle position. However, the movements were 10 times smaller than reported in earlier studies of the reciprocal straddle position. CONCLUSIONS: It was possible to demonstrate reciprocal movements of the sacroiliac joints in the straddle position. However, the radiostereometric analysis technique showed the movements to be small, as reported in other mobility studies.

Adult↗
PubMed1987

Functional impairment of the sacroiliac joint after total hip replacement.

Fifty patients who underwent total hip replacement were examined within 3 months by two independent investigators with respect to functional impairment of the sacroiliac joint. Several well-defined clinical tests were used, e.g. spine test, standing flexion test, Menell's sign, tenderness of the sacroiliac joint. The results of both investigators were comparable, with corresponding results in 94 per cent. Nearly 30 per cent of the patients showed functional impairment of one sacroiliac joint. This finding may partly cause the gluteal or low back pains which are reported by patients after hip replacement.

Aged↗