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PubMedDate not supplied

Scintigraphy of the sacroiliac joint region in asymptomatic riding horses: scintigraphic appearance and evaluation of method.

The sacroiliac region in 33 clinically normal riding horses was examined with scintigraphy to determine the normal scintigraphic appearance, to evaluate a semiquantitative method used to calculate a sacroiliac joint (SI joint) ratio, and to identify factors that affect the scintigraphic appearance of the pelvis. The scintigraphic examination included dorsal views of each SI joint region and one lateral view of the urinary bladder. Two predefined areas (the SI joint and the area between the tuber sacrale and the SI joint) were evaluated subjectively by comparing the intensity in each area to the intensity in the tuber sacrale, and a semiquantitative method was applied on the images to calculate an SI joint ratio. The thickness of the muscle mass overlying each SI joint was measured by using ultrasound. A corrected ratio was calculated based on a corrected pixel count for each SI joint. Of 29 evaluated horses, 28 had normal radiotracer uptake in the SI joints and 10 horses had symmetric normal radiotracer uptake in the area between the tuber sacrale and the SI joint. The mean SI joint ratio was 0.53 on both the left and right sides, and the mean corrected SI joint ratio was 2.15 on the left side and 2.13 on the right side. Factors that affect the scintigraphic appearance of the pelvis were identified and included attenuation, radioactive urine, and muscle symmetry. The muscle thickness ranged from 8-11 cm, causing 71-82% attenuation. Radioactive urine in the urinary bladder was located ventral to the SI joint region in 16 horses, and four of these were excluded from further evaluation because of risk of misinterpretation. A visual assessment of symmetry of the horses' gluteal muscle mass was compared with the ultrasound measurements. Fourteen horses (14/33) were regarded symmetric by both techniques. Soft tissue attenuation was found to severely compromise the result and indicated that only lesions in the SI joint with severely increased radiotracer uptake can be detected with scintigraphy. Knowledge about presence of radioactive urine ventral to the SI joint region and assessment of muscle symmetry is essential for a correct subjective evaluation. Any situation with difference in muscle mass between the left and right side of the pelvis will give a false impression of increased radiotracer uptake on the side with lesser muscle mass.

Animals↗
PubMed2003

The functional relationship between the craniomandibular system, cervical spine, and the sacroiliac joint: a preliminary investigation.

The hypothesis of a functional coupling between the muscles of the craniomandibular system and the muscles of other body areas is still controversial. The purpose of this pilot study was to examine whether there is a relationship between the craniomandibular system, the craniocervical system and the sacropelvic region. To test this hypothesis, the prevalence and localization of dysfunction of the cervical spine and the sacroiliac joint were examined in a prospective, experimental trial. Twenty healthy students underwent an artificial occlusal interference, which caused an occlusal interference. The upper cervical spine (CO-C3) and the sacroiliac joint were examined before, during and after this experimental test. The primary outcome with these experimental conditions was the occurrence of hypomobile functional abnormalities. In the presence of occlusal interference, functional abnormalities were detected in both regions examined and these changes were statistically significant. The clinical implications of these findings may be that a complementary examination of these areas in CMD patients could be useful.

Adult↗
PubMed1997

Bilateral fracture dislocation of the sacroiliac joint.

We present a rare case of a 27-year-old man sustaining a bilateral fracture dislocation of the sacroiliac joints without disruption of the anterior pelvis, following a fall from a height. Reconstructed images in the coronal plane and three-dimensional CT images were invaluable in the diagnosis and assessment of this injury.

Accidental Falls↗
PubMed2006

Anatomy of the interosseous region of the sacroiliac joint.

STUDY DESIGN: Anatomical study of the interosseous region of the sacroiliac joint (SIJ) complex. OBJECTIVES: To document and quantify the surface topography of the interosseous region of the SIJ. BACKGROUND: A review of the literature reveals that little consideration has been given to the interosseous region of the SIJ anatomically, biomechanically, and clinically. METHODS AND MEASURES: The interosseous region of 11 cadaveric specimens (9 formalin embalmed and 2 fresh frozen) were studied. Ten specimens were 55 years of age or older and 1 was 20 years old. To view the interosseous surfaces of the sacrum and ilium the specimens were either axially sectioned (1-cm slices) or disarticulated. One fresh-frozen and 6 embalmed specimens were disarticulated and the remainder axially sectioned. The topography (surface ridging and areas of ossification) of the interosseous region was documented in all specimens and in 2 specimens the surfaces were 3-dimensionally reconstructed using modeling and animation software (MAYA; Autodesk, Inc, San Rafael, CA). RESULTS: Surface characteristics of the SIJ complex observed in specimens 55 years of age or older included moderate to extensive ridging of the interosseous region of the sacrum and ilium in 100% of specimens and ossification of the central interosseous region of the sacroiliac (SI) ligament in 60% of specimens. CONCLUSIONS: Central region ossification of the interosseous SI ligament and the presence of ridges and depressions over the opposing interosseous surfaces of the sacrum and ilium are features common to specimens that are in or beyond their sixth decade. These findings further support the contention that there is little to no movement available at this joint in older individuals.

Adult↗
PubMed2003

The sacroiliac joint: a potential cause of pain after lumbar fusion to the sacrum.

The sacroiliac joint (SIJ) can cause pain after lumbosacral fusion. Diagnosis requires >75% relief after local anesthetic SIJ injection. This study is a retrospective review of patients with low back pain after lumbosacral fusion who had SIJ injections. Percentage and duration of pain relief were noted. Results are as follows: there were 34 patients; 8 fused at L5-S1, 14 fused at L4-S1, and 12 had multilevel fusions. Twenty had >75% relief within 45 minutes, and 11 had prolonged relief. Six had relief >20% but <75%, and one had prolonged relief. Eight never improved. Eight had posterior iliac crest bone harvested, and there was no correlation between donor side and pain side. In 34 patients with low back pain after lumbosacral fusion, SIJ was the cause of pain in 32% and possibly the cause in 29%. This is the first detailed description of this problem.

Adult↗
PubMed1998

Variation in the appearance of the normal sacroiliac joint on pelvic CT.

OBJECTIVE: To describe the CT appearance of the ageing sacroiliac joints (SJ) and correlate the radiological findings with patients' gender, body mass index (BMI) and, in women, parity. MATERIALS AND METHODS: The study population included 288 consecutive patients who underwent pelvic CT for various indications not related to SJ diseases. Patients were stratified by age, BMI and parity in women. The joint space and subchondral sclerosis were assessed and the presence of osteophytes, ankylosis, erosions, subchondral cysts and vacuum phenomena were noted on bone window settings. RESULTS: The widths of the SJ space and of the subchondral sclerosis on the iliac and sacral sides were 2.3+/-0.4mm, 2.5+/-1.6mm and 1.4+/-0.5mm, respectively, in patients younger than 40 years of age and 1.9+/-0.2 mm, 3.6+/-2.1 mm and 2.3+/-1.1 mm, respectively, in patients older than 40 years of age. The joint space tends to become narrow and less uniform with advancing age, while subchondral sclerosis appeared to be wider and less uniform in the elderly. Osteophytes were present even in younger patients and their prevalence increased with advancing age. Ankylosis and erosions were rare findings, observed only after the fifth decade of life. A higher prevalence of asymmetric non-uniform SJ space, ill-defined, non-uniform, extensive subchondral sclerosis and ankylosis was observed in women, obese and multiparous mothers than the age matched men, normal weighted individuals and non-multiparous women, respectively. CONCLUSION: Conventional pelvic CT can provide valuable information concerning the SJ, when reviewed on bone window settings. The CT appearance of the SJ is closely related to patients age, gender, BMI and, in women, parity. Knowledge of the spectrum of radiological findings observed in the normal population may be useful when interpreting examinations of patients with SJ disease.

Adolescent↗
PubMed2000

Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability.

In the literature concerning the sacroiliac joint (SIJ) there are numerous specific tests used to detect joint mobility or pain provocation. In this article the authors have reviewed 11 studies which investigated the reliability of these tests. The methodological quality of the studies was tested by a list of criteria developed by the authors. This list consisted of three categories: (1) study population, (2) test procedures and (3) test results. To each criterion a weighting was attached. The methodological score for nine out of the 11 studies was found to be acceptable. The results of this review, however, could not demonstrate reliable outcomes and therefore no evidence on which to base acceptance of mobility tests of the SIJ into daily clinical practice. There are no indications that 'upgrading' of methodological quality would have improved the final conclusions. With respect to pain provocation tests, the findings did not show the same trend. Two studies demonstrated reliable results using the Gaenslen test and the Thigh thrust test. One study showed acceptable reliability for five other pain provocation tests; however, since other authors have described contradictory results, there is a necessity for further research in this area with an emphasis on multiple test scores and pain provocation tests of the SIJ.

Humans↗
PubMed2002

Fluoroscopy-guided sacroiliac joint injections with phenol ablation for persistent sacroiliitis: a case series.

In this article we are reporting on the use of fluoroscopy-guided 6% Phenol injections for the ablation of the sacroiliac joints (SIJs), utilizing retrospective review of case reports. We reviewed 10 patients (7 male and 3 female) who have known sacroiliitis proven by fluoroscopically guided sacroiliac joint (SIJ) injection (age ranged from 25 to 78). They all had 2 to 4 weeks of relief after the injections utilizing Bupivacaine 0.5% and 80 mg of depomedrol. They all had repeat fluoroscopy-guided injections of the SIJs with neurolysis of either a unilateral SIJ or bilateral SIJs using 6% Phenol. Phenol 6% with saline 2.5 cc per joint was injected; the needle was cleared with local anesthetic before removing it from the joint. Twenty percent of the patients had a greater than 70% improvement with an average duration of 24 weeks. Sixty percent of the patients had a 50% to 70% improvement with an average duration of 20 weeks. Ten percent had a 20% to 50% improvement with a total duration of 12 1/2 weeks. Ten percent had a less than 20% improvement. With intra-articular injections of phenol for the ablation of the SIJs, we have found a significant improvement in pain relief accompanied by prolonged duration of relief.

Journal Article↗
PubMed1986

Hamstring muscle strain treated by mobilizing the sacroiliac joint.

The purpose of this study was to compare the effectiveness of two types of treatment of hamstring muscle strains. Twenty patients with hamstring muscle strains were assigned randomly to an Experimental Group (n = 10) or a Control Group (n = 10). Peak torque production of the quadriceps femoris and hamstring muscles and hamstring muscle length were measured before and after treatment. The hamstring muscles of the Experimental and Control groups were treated with moist heat followed by passive stretching. The Experimental Group also received manipulation of the sacroiliac joint. The change in hamstring muscle peak torque was significantly greater for the Experimental Group than for the Control Group (p less than .005). No significant differences existed between the two groups in either quadriceps femoris muscle peak torque or hamstring muscle length. The results of this study suggest a relationship between sacroiliac joint dysfunction and hamstring muscle strain.

Adolescent↗
PubMed1989

Movements of the sacroiliac joints. A roentgen stereophotogrammetric analysis.

Twenty-five patients (21 females and 4 males) with sacroiliac joint disorders were studied with roentgen stereophotogrammetry in physiologic positions as well as in the extreme of physiologic positions. There was a constant pattern of motion with different load, especially around the transverse axis. The rotations were small and in mean between position 2.5 degrees (0.8 degree-3.9 degrees). The translation was, mean, 0.7 mm (0.1-1.6 mm). There was no difference between symptomatic and asymptomatic joints.

Humans↗
PubMed2001

Sacroiliac joint dysfunction: a long-term follow-up study.

Sixty-nine patients with sacroiliac joint dysfunction were prospectively evaluated and treated with a structured physical therapy program. Follow-up clinical outcome was obtained from a patient questionnaire administered by an independent reviewer a minimum of 2 years after treatment. Average patient age was 40 years, and 80% were women. Ninety-five percent rated their result as good or excellent, while 5% believed their outcome was fair or poor. A structured physical therapy program can produce good long-term results in most patients; however, 5% continue to be symptomatic. This small subset may be candidates for more invasive evaluation.

Adolescent↗
PubMed2004

[Technique and radiation dose of conventional X-rays and computed tomography of the sacroiliac joint].

Anterior-posterior (a.p.) or posterior-anterior X-rays of the sacroiliac joint, sometimes supplemented by a transverse view, have been the method of choice for diagnosis of patients suspected of having sacroiliitis. The sensitivity and specificity of conventional X-rays are relatively low, which can delay the diagnosis of sacroiliitis. Computed tomography (CT) is superior to conventional X-rays for diagnosis of sacroiliitis, but does emit a relatively higher dose of radiation. For this reason, particularly for females, CT should be optimized by employing semi-coronal planes which require a lower radiation dose than axial planes. CT in a semi-coronal plane causes minimal radiation to the ovaries, and the effective radiation dose for women might even be lower than with conventional AP X-rays. Therefore, for suspected sacroiliitis in young women, CT in the semi-coronal plane is the preferred imaging method with respect to diagnostics and radiation protection when magnetic resonance imaging (MRI) is not available. Male gonads can be protected from radiation doses in conventional X-rays, and CT as the primary imaging method can only be justified in these cases because of its better diagnostic capabilities. Due to the lack of inherent risk factors, MRI is superior to CT for diagnostics since it provides images of inflammatory signs in addition to joint destruction. Thus, when available, MRI should be given preference for diagnosis of sacroiliitis.

Diagnosis, Differential↗
PubMed1981

[The scintigraphic investigation of the sacroiliac joints in ankylosing spondylitis ].

Quantitative sacroiliac scintigraphy was performed in 41 patients with ankylosing spondylitis (Sp.a.) and in 90 control subjects. The sacroiliac/sacrum ratio (Index ISG/sacrum) was calculated. We examined the correlation between activity ratio on the one hand and age, subjective complaints, erythrocyte sedimentation rate, and antiinflammatory therapy on the other. Significantly increased uptakes were found in the patient group as a whole compared with the controls. The activity index was highest in the early periods of the disease, so we conclude that scintigraphy is useful in the early diagnosis of Sp.a.

Adult↗