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Sacroiliac joint injections

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https://www.readbyqxmd.com/read/28676368/interventional-management-for-pelvic-pain
#1
REVIEW
Ameet S Nagpal, Erika L Moody
Interventional procedures can be applied for diagnostic evaluation and treatment of the patient with pelvic pain, often once more conservative measures have failed to provide relief. This article reviews interventional management strategies for pelvic pain. We review superior and inferior hypogastric plexus blocks, ganglion impar blocks, transversus abdominis plane blocks, ilioinguinal, iliohypogastric and genitofemoral blocks, pudendal nerve blocks, and selective nerve root blocks. Additionally, we discuss trigger point injections, sacroiliac joint injections, and neuromodulation approaches...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28658160/the-effect-of-intra-articular-stimulation-by-pulsed-radiofrequency-on-chronic-sacroiliac-joint-pain-refractory-to-intra-articular-corticosteroid-injection-a-retrospective-study
#2
Min Cheol Chang, Sang Ho Ahn
We investigated the degree of pain reduction following intra-articular (IA) pulsed radiofrequency (PRF) stimulation of the sacroiliac joint (SIJ) in patients with chronic SIJ pain that had not responded to IA corticosteroid injection. Twenty patients were recruited. Clinical outcomes after applying PRF stimulation of the SIJ were evaluated by a numeric rating scale (NRS) and a 7-point Likert scale. The NRS scores significantly changed over time. The NRS scores at 1, 2, and 3 months after PRF were significantly lower than those before PRF...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28652915/ablation-of-the-sacroiliac-joint-using-mr-guided-high-intensity-focused-ultrasound-a-preliminary-experiment-in-a-swine-model
#3
Elena A Kaye, Majid Maybody, Sebastien Monette, Stephen B Solomon, Amitabh Gulati
BACKGROUND: Dysfunction of the Sacroiliac Joint (SIJ) is one of the key sources of low back pain. For prolonged pain relief, some patients undergo fluoroscopic guided radio-frequency (RF) ablation of SIJ, during which a number of RF probes are inserted to create thermal lesions that disrupt the posterior sacral nerve supply. This procedure is minimally invasive, laborious, time-consuming and costly. To study if High Intensity Focused Ultrasound (HIFU) ablation is a feasible alternative approach to SIJ pain treatment, we performed experiments using HIFU to ablate SIJ in the swine model...
2017: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/28640088/safety-of-tumor-necrosis-factor-alpha-inhibitors-for-treatment-of-ankylosing-spondylitis-a-meta-analysis
#4
REVIEW
Zeren Ma, Xiaoping Liu, Xiaosheng Xu, Jie Jiang, Jian Zhou, Jia Wang, Dewang Chen, Song Luo
BACKGROUND: Ankylosing spondylitis (AS) is a chronic immune-mediated disease affecting the sacroiliac joints and the spine, manifesting with new bone formation and osteopenia. Five tumor necrosis factor-alpha (TNF-α) inhibitors (infliximab, etanercept, adalimumab, certolizumab, and golimumab) are available for the treatment of AS, however, the results for the safety of TNF-α inhibitors in the treatment of AS are not consistent. METHODS: In this study, we conducted a meta-analysis to determine the safety of TNF-α inhibitors compared with placebo in reducing pain, swelling, and inflammation of AS patients...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28600004/the-sacroiliac-joint
#5
REVIEW
David W Polly
The sacroiliac joint moves 2.5°. It is innervated with nociceptive fibers. It is a common cause of low back pain (15%-30%). Degenerative changes occur, especially after lumbosacral fusion. When performed in series, physical examination maneuvers are diagnostic. Confirmatory image-guided injections can aid the diagnosis. In randomized clinical trials, surgical treatment in appropriately selected patients has been demonstrated to be statistically and clinically superior to nonsurgical management.
July 2017: Neurosurgery Clinics of North America
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
#6
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/28514779/low-back-pain-in-pregnancy-investigations-management-and-role-of-neuraxial-analgesia-and-anaesthesia-a-systematic-review
#7
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/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
#8
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...
July 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28410481/leg-symptoms-associated-with-sacroiliac-joint-disorder-and-related-pain
#9
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
#10
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...
June 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#11
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
https://www.readbyqxmd.com/read/28339540/interventional-pain-management-for-sacroiliac-tumors-in-the-oncologic-population-a-case-series-and-paradigm-approach
#12
Nathan Hutson, Joseph C Hung, Vinay Puttanniah, Eric Lis, Ilya Laufer, Amitabh Gulati
Introduction: Tumors invading the sacrum and/or ilium often represent incurable metastatic disease, and treatment is targeted toward palliation of symptoms and control of pain. As systemic opioid therapy is frequently inadequate and limited by side effects, a variety of interventional techniques are available to better optimize analgesia. Using six patients as a paradigm for interventional approaches to pain relief, we present a therapeutic algorithm for treating sacroiliac tumor-related pain in the oncologic population...
May 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28243380/patient-reported-outcomes-from-sacroiliac-joint-fusion
#13
Vamsi K Kancherla, Shane M McGowan, Brittany N Audley, Gbolabo Sokunbi, Steven T Puccio
STUDY DESIGN: Retrospective, case series. PURPOSE: The purpose of this study is to determine morbidity, complications, and patient reported outcomes from minimally invasive sacroiliac joint (SIJ) fusion. OVERVIEW OF LITERATURE: Lumbar back pain emanating from the SIJ can be surgically treated via a percutaneous approach in the appropriately selected patient with minimal morbidity and acceptable functional outcomes. METHODS: Patients diagnosed by >2 physical examination maneuvers and subjective relief from a computed tomography-guided lidocaine-bupivacaine-steroid injection underwent SIJ fusion after failing conservative management with a combination of oral anti-inflammatory medications, physical therapy, and pelvic belt stabilization...
February 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28178092/a-randomized-comparison-between-ultrasound-and-fluoroscopy-guided-sacral-lateral-branch-blocks
#14
Roderick J Finlayson, John-Paul B Etheridge, Maria Francisca Elgueta, Atikun Thonnagith, Frederick De Villiers, Bill Nelems, De Q Tran
BACKGROUND AND OBJECTIVES: This randomized trial compared ultrasound (US)- and fluoroscopy-guided sacral lateral branch (SLB) blocks. We hypothesized that US would require a shorter performance time. METHODS: Forty patients who required unilateral sacral lateral branch blocks for chronic low back pain were randomized to US or fluoroscopy guidance. Before the performance of the assigned block, an investigator who was not involved in patient care carried out baseline analgesic testing...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28093372/does-trainee-involvement-in-fluoroscopic-injections-affect-fluoroscopic-time-immediate-pain-reduction-and-complication%C3%A2-rate
#15
Daniel Cushman, Masaru Teramoto, Bradley Curtis, David T Lee, Austin Marcolina, Zachary McCormick
BACKGROUND: Patients have expressed concern about undergoing procedures involving trainees, even with direct attending physician supervision. Little literature has examined the effect of trainee involvement on patient outcomes. OBJECTIVE: We aimed to evaluate the effect of trainee involvement on patient complications, immediate pain reduction, and fluoroscopic time for different fluoroscopic injection types. DESIGN: Retrospective review. SETTING: Four academic outpatient institutions with Accreditation Council for Graduate Medical Education (ACGME)-accredited residency (physical medicine and rehabilitation, or anesthesiology) or fellowship (sports medicine or pain medicine) programs from 2000 to 2015...
January 16, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28039353/fluoroscopy-guided-sacroiliac-intraarticular-injection-via-the-middle-portion-of-the-joint
#16
Daisuke Kurosawa, Eiichi Murakami, Toshimi Aizawa
OBJECTIVE : Sacroiliac intraarticular injection is necessary to confirm sacroiliac joint (SIJ) pain and is usually performed via the caudal one-third portion of the joint. However, this is occasionally impossible for anatomical reasons, and the success rate is low in clinical settings. We describe a technique via the middle portion of the joint. DESIGN : Observational study. SUBJECTS : Enrolled were 69 consecutive patients (27 men and 42 women, with an average age of 53 years) in whom the middle portion of 100 joints was targeted...
December 30, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27914184/the-potential-use-of-ultrasound-magnetic-resonance-imaging-fusion-applications-in-musculoskeletal-intervention
#17
Christopher J Burke, Jenny Bencardino, Ronald Adler
We sought to assess the potential use of an application allowing real-time ultrasound spatial registration with previously acquired magnetic resonance imaging in musculoskeletal procedures. The ultrasound fusion application was used to perform a range of outpatient procedures including piriformis, sacroiliac joint, pudendal and intercostal nerve perineurial injections, hamstring-origin calcific tendonopathy barbotage, and 2 soft tissue biopsies at our institution in 2015. The application was used in a total of 7 procedures in 7 patients, all of which were technically successful...
January 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27906943/fluoroscopic-sacroiliac-joint-injection-is-oblique-angulation-really-necessary
#18
Sandeep Khuba, Anil Agarwal, Sujeet Gautam, Sanjay Kumar
BACKGROUND: The conventional technique for sacroiliac (SI) joint injection involves aligning the anterior and posterior aspects of the SI joint under fluoroscopic guidance and then entering the SI joint in the most caudal aspect. OBJECTIVE: We wish to highlight that there is no added advantage to aligning both the anterior and posterior joint lines of the SI joint as it is time consuming, associated with additional radiation exposure, and may make the entry into the posterior SI joint technically more difficult...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27866812/a-case-report-of-infectious-sacroiliitis-in-an-adult-presenting-to-the-emergency-department-with-inability-to-walk
#19
Douglas Brtalik, Manoj Pariyadath
BACKGROUND: Infectious sacroiliitis (ISI) is an uncommon cause of back and hip pain in which the sacroiliac joint, either unilateral or bilateral, is inflamed from an infectious source. Historically, this has been an easily missed diagnosis due to nonspecific presenting symptoms along with subtle nondistinguishable laboratory abnormalities. CASE REPORT: We describe an injection drug user presenting with right-sided ISI who presented with hip and back pain and inability to walk...
March 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27770148/-technique-and-efficiency-of-ultrasound-guided-injections-in-the-sacroiliac-joint-for-pediatric-treatment-of-sacroiliitis
#20
M-A Weber
No abstract text is available yet for this article.
December 2016: Der Radiologe
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