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Sacroiliac pain

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https://www.readbyqxmd.com/read/28521343/tarlov-cyst-causing-sacral-insufficiency-fracture
#1
Ross C Puffer, Marcus J Gates, William Copeland, William E Krauss, Jeremy Fogelson
BACKGROUND AND IMPORTANCE: Tarlov cysts, also known as perineural cysts, have been described as meningeal dilations of the spinal nerve root sheath between the peri- and endoneurium at the dorsal root ganglion. Most often they are found in the sacrum involving the nerve roots. Normally asymptomatic, they have been reported to present with radiculopathy, paresthesias, and even urinary or bowel dysfunction. Sacral insufficiency has not been a well-documented presentation. CLINICAL PRESENTATION: The patient is a 38-year-old female who started to develop left low back pain and buttock pain that rapidly progressed into severe pain with some radiation down the posterior aspect of her left leg...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28521006/does-immediate-pain-relief-after-an-injection-into-the-sacroiliac-joint-with-anesthetic-and-corticosteroid-predict-subsequent-pain-relief
#2
Byron J Schneider, Lisa Huynh, Josh Levin, Pranathip Rinkaekan, Ramin Kordi, David J Kennedy
Objectives. : To determine if immediate pain response following an injection with local anesthetic and corticosteroid predicts subsequent relief. Design.:  Prospective observational cohort. Setting.:  An institutional review board-approved prospective study from a single academic medical center. Methods.:  Patients with clinical diagnosis of sacroiliac (SIJ) pain and referred for SIJ injection were enrolled; 1 cc of 2% lidocaine and 1 cc of triamcinolone 40 mg/mL were injected into the SIJ...
May 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28520623/the-sub-crestal-iliac-screw-a-technical-note-describing-a-free-hand-in-line-low-profile-iliac-screw-insertion-technique-to-avoid-side-connector-use-and-reduce-implant-complications
#3
Gabriel Liu, Muhammed Yaser Hasan, Hee-Kit Wong
STUDY-DESIGN: Case-series. OBJECTIVE: Report our modified iliac-screw insertion technique and its clinical outcomes. SUMMARY OF BACKGROUND DATA: Iliac-screws are one of the preferred methods for modern spinopelvic-fixation. However the technique is not without complications, predominantly due to iliac-screw head prominence, leading to pain and revisions. Conventional iliac-screw entry point is sited superficially at the posterior-superior-iliac-spine (PSIS) contributing to screw-head prominence...
May 17, 2017: Spine
https://www.readbyqxmd.com/read/28514779/low-back-pain-in-pregnancy-investigations-management-and-role-of-neuraxial-analgesia-and-anaesthesia-a-systematic-review
#4
Herman Sehmbi, Rohan D'Souza, Anuj Bhatia
BACKGROUND: Low back pain (LBP) is commonly experienced during pregnancy and is often poorly managed. There is much ambiguity in diagnostic work-up, appropriate management and decision-making regarding the use of neuraxial analgesia and anaesthesia during labour and delivery in these patients. This systematic review summarises the evidence regarding investigations, management strategies and considerations around performing neuraxial blocks for pregnant women with LBP. METHODS: We searched 3 databases and reviewed literature concerning LBP in pregnancy with regards to diagnostic modalities, management strategies and use of neuraxial techniques for facilitating labour and delivery...
May 18, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28512691/complete-circumferential-osseous-extension-in-the-acetabular-rim-occurs-regardless-of-acetabular-coverage
#5
Keisuke Watarai, Fumihiko Kimura, Yuho Kadono, Yoon Taek Kim, Mamoru Niitsu, Hiromi Oda, Hirohiko Azuma
BACKGROUND: Complete circumferential osseous extension in the acetabular rim has been reported to occur in the deep hip with pincer impingement. However, this phenomenon occasionally is observed in dysplastic hips without pincer impingement, and the degree to which this finding might or might not be associated with hip pain, and how often it occurs bilaterally among patients, are not well characterized. QUESTIONS/PURPOSES: (1) To determine the proportion of patients with complete circumferential osseous extension in the acetabular rim using three-dimensional (3-D) CT in patients with and without hip pain who had CT scans obtained for various reasons...
May 16, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28499364/clinical-classification-in-low-back-pain-best-evidence-diagnostic-rules-based-on-systematic-reviews
#6
Tom Petersen, Mark Laslett, Carsten Juhl
BACKGROUND: Clinical examination findings are used in primary care to give an initial diagnosis to patients with low back pain and related leg symptoms. The purpose of this study was to develop best evidence Clinical Diagnostic Rules (CDR] for the identification of the most common patho-anatomical disorders in the lumbar spine; i.e. intervertebral discs, sacroiliac joints, facet joints, bone, muscles, nerve roots, muscles, peripheral nerve tissue, and central nervous system sensitization...
May 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28492440/diskitis-osteomyelitis-spinal-epidural-abscess-meningitis-and-endocarditis-following-sacroiliac-joint-injection-for-the-treatment-of-low-back-pain-in-a-patient-on-therapy-for-hepatitis-c-virus
#7
Geeta Nagpal, John P Flaherty, Honorio T Benzon
OBJECTIVE: Sacroiliac joint injections are frequently performed procedures in the management of acute and chronic low-back pain, including patients with various immunocompromised states. Infectious complications following these procedures along with other spinal injections are rarely reported, but the true incidence is unknown. The purpose of this report is to highlight the devastating neurologic sequela that can occur, and to discuss potential future management strategies. CASE REPORT: We present a patient who developed diskitis, osteomyelitis, spinal epidural abscess, meningitis, and endocarditis from Staphylococcus aureus, all of which developed shortly after a sacroiliac joint injection...
May 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28473095/acr-appropriateness-criteria-%C3%A2-chronic-back%C3%A2-pain%C3%A2-suspected-sacroiliitis-spondyloarthropathy
#8
Stephanie A Bernard, Mark J Kransdorf, Francesca D Beaman, Ronald S Adler, Behrang Amini, Marc Appel, Erin Arnold, R Carter Cassidy, Bennett S Greenspan, Kenneth S Lee, Michael J Tuite, Eric A Walker, Robert J Ward, Daniel E Wessell, Barbara N Weissman
Inflammatory sacroiliitis or the seronegative axial spondyloarthropathies often presents as back pain or sacroiliac joint pain of more than 3-month duration with inflammatory symptoms and typically in patients younger than 45 years of age. Imaging plays an important role in diagnosis and disease monitoring. This article addresses the appropriate sequence of initial imaging for evaluation of a suspected spondyloarthropathy, the imaging follow-up of treatment response and the special considerations for imaging of trauma in patients with ankylosis of the spine...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28431581/sacroiliitis-mimics-a-case-report-and-review-of-the-literature
#9
Maria J Antonelli, Marina Magrey
BACKGROUND: Radiographic sacroiliitis is the hallmark of ankylosing spondylitis (AS), and detection of acute sacroiliitis is pivotal for early diagnosis of AS. Although radiographic sacroiliitis is a distinguishing feature of AS, sacroiliitis can be seen in a variety of other disease entities. CASE PRESENTATION: We present an interesting case of sacroiliitis in a patient with Paget disease; the patient presented with inflammatory back pain which was treated with bisphosphonate...
April 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28431026/minimally-invasive-sacroiliac-joint-fusion-radiofrequency-denervation-and-conservative-management-for-sacroiliac-joint-pain-6-year-comparative-case-series
#10
Vicente Vanaclocha, Juan Manuel Herrera, Nieves Sáiz-Sapena, Marlon Rivera-Paz, Francisco Verdú-López
BACKGROUND: Sacroiliac joint (SIJ) pain is an under-recognized condition. Substantial information supports the safety and effectiveness of SIJ fusion (SIJF). Long-term follow-up after SIJF has not been reported. OBJECTIVE: To determine responses to conservative management (CM), SIJ denervation, and SIJF in patients with SIJ pain unresponsive to CM. METHODS: Retrospective study with long-term (up to 6 yr) follow-up of 137 patients with SIJ pain seen in an outpatient neurosurgery clinic who received either CM (n = 63), sacroiliac denervation (n = 47), or minimally invasive SIJF (n = 27)...
April 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28426912/the-association-between-inflammatory-back-pain-characteristics-and-mri-findings-in-the-spine-and-sacroiliac-joints
#11
Bodil Arnbak, Anne G Jurik, Tue S Jensen, Claus Manniche
OBJECTIVE: To investigate the association between MRI findings at the sacroiliac joints (SIJs) and vertebral endplates and pain characteristics assumed to be indicative of axial inflammation. METHODS: Patients aged 18-40 years with persistent low back pain referred to an outpatient spine clinic participated, including an unknown proportion of axial spondyloarthritis patients. Data included MRI of the spine and SIJs and self-reported responses to questions covering the Calin, Berlin, ASAS and Bailly inflammatory back pain (IBP) definitions...
April 20, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28418950/sacral-fatigue-fracture-in-a-military-recruit
#12
Matthew D Burgess, Mickaila J Johnston, Eugene D Silverman
A 19-year-old male military recruit presented with 3 weeks of persistent left hip and groin pain after abnormally twisting his hip during a hike. Initial radiographs were interpreted as negative. He subsequently underwent a bone scan which revealed linear left sacral uptake along or paralleling the sacroiliac joint. Differential diagnostic considerations included unilateral sacroiliitis and sacral fracture. SPECT/CT was performed which confirmed left sacral fatigue stress fracture. Transitional lumbosacral anatomy was evident on radiographs with pseudoarticulation of the transitional left S1 transverse process with the sacrum...
June 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28414677/a-rare-case-of-tropical-pyomysitis-acquired-on-vacation-in-a-healthy-male
#13
K Poole, T Tran
INTRODUCTION: Pyomyositis has traditionally been considered a tropical disease. Increasing prevalence has been observed in more northern climates, especially with HIV, immunosuppression, and IV drug abuse as predisposing factors. Pyomyositis has the tendency to mimic other conditions, such as muscle contusion, necrotizing fasciitis, or septic arthritis. The rarity of this disease and non-specificity of its symptoms often lead to delay in appropriate diagnosis and treatment. CASE: 24-year-old man, seen 2 days prior in orthopedics clinic and the Emergency Department for persistent gluteal pain thought to be due to right-sided sciatica, was admitted following worsening pain, diffuse generalized weakness with polyarthralgias and myalgias These symptoms were associated with night sweats, shaking chills, and difficulty walking...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28410481/leg-symptoms-associated-with-sacroiliac-joint-disorder-and-related-pain
#14
Eiichi Murakami, Toshimi Aizawa, Daisuke Kurosawa, Kyoko Noguchi
OBJECTIVE: The symptoms of sacroiliac joint (SIJ) disorders are usually detected in the buttock and groin, and occasionally referred to the thigh and leg. However, lumbar disorders also cause symptoms in these same body regions. The presence of a characteristic, symptomatic pattern in the legs would be useful for diagnosing SIJ disorders. This study aimed to identify specific leg symptoms in patients with SIJ pain originating from the posterior sacroiliac ligament and determine the rate of occurrence of these symptoms...
June 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28399606/-diagnosis-of-patients-with-painful-sacroiliac-joint-syndrome
#15
Rahel Bornemann, Robert Pflugmacher, Ernst M W Koch, Philip Peter Roessler, Yorck Rommelspacher, Dieter Christian Wirtz, Sönke Percy Frey
Pain coming from the sacroiliac (SI) joints can explain up to 25 % of all chronic low back pain. A careful differential diagnosis is required to avoid misdiagnosis of low back pain. In addition to historical findings, positive findings on physical examination maneuvers that stress the SI joint are a key component diagnosis. The SI joint is confirmed as a pain generator when intraarticular injection of local anaesthetics provides acute back pain relief. Minimally invasive SI joint fusion is clearly superior to invasive open surgical procedures, with decreased blood loss and tissue disruption, shorter procedure times and shorter hospital stays...
April 11, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28388969/is-ct-indicated-in-diagnosing-sacroiliac-joint-degeneration
#16
J Bäcklund, E Clewett Dahl, M Skorpil
AIM: To assess the value of computed tomography (CT) in the diagnosis of symptomatic sacroiliac (SI) joint degeneration. MATERIALS AND METHODS: CT images from 123 patients with clinically diagnosed SI joint pain were compared to age- and gender-matched controls without chronic back pain or previous back surgery. Degeneration was graded assessing joint space narrowing, osteophytes, subchondral sclerosis, cysts, and vacuum phenomena. RESULTS: The mean total score for the patients was 9...
April 4, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28377866/revision-of-minimally-invasive-sacroiliac-joint-fixation-technical-considerations-and-case-studies-using-decortication-and-threaded-implant-fixation
#17
Brett MenMuir, Louis C Fielding
BACKGROUND: Sacroiliac joint (SIJ) disease is increasingly recognized as a common source of low back pain. Arthrodesis of the SIJ has been shown to be clinically effective for this condition. In the last decade, minimally invasive (MI) SIJ fusion procedures have been developed to achieve the clinical effectiveness of open fusion procedures, with lower operative morbidity and faster recovery. However, SIJ fusion patients occasionally present with symptomatic nonunions necessitating revision...
2017: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/28350586/predictors-of-outcome-in-conservative-and-minimally-invasive-surgical-management-of-pain-originating-from-the-sacroiliac-joint-a-pooled-analysis
#18
Julius Dengler, Bradley Duhon, Peter Whang, Clay Frank, John Glaser, Bengt Sturesson, Steven Garfin, Daniel Cher, Aaron Rendahl, David Polly
STUDY DESIGN: A pooled patient-level analysis of two multicenter randomized controlled trials and one multicenter single-arm prospective trial. OBJECTIVE: To identify predictors of outcome of conservative and minimally invasive surgical management of pain originating from the sacroiliac joint (SIJ). SUMMARY OF BACKGROUND DATA: Three recently published prospective trials have shown that minimally invasive SIJ fusion (SIJF) using triangular titanium implants produces better outcomes than conservative management for patients with pain originating from the SIJ...
March 27, 2017: Spine
https://www.readbyqxmd.com/read/28340063/conventional-simplicity-iii-and-cooled-sinergy-radiofrequency-for-sacroiliac-joint-denervation-one-year-retrospective-study-comparing-two-devices
#19
Andrea Tinnirello, Sandra Barbieri, Manuel Todeschini, Maurizio Marchesini
Objective. : To compare two radiofrequency (RF) devices, Simplicity III (conventional RF), and SInergy (cooled RF), which are specifically designed to denervate the sacroiliac joint (SIJ). Design. : Retrospective observational study. Setting. : Italian National Health Service Public Hospital. Subjects.:  Forty-three patients with SIJ-derived pain refractory to conservative treatment; 21 and 22 patients, respectively, received Simplicity III or SInergy to denervate the SIJ...
March 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#20
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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