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Sacroiliac joint injections

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https://www.readbyqxmd.com/read/29871369/a-prospective-randomized-noninferiority-trial-comparing-upper-and-lower-one-third-joint-approaches-for-sacroiliac-joint-injections
#1
Sang Hyun Hong, Hyewon Chung, Chang Hee Lee, Young Hoon Kim
BACKGROUND: Sacroiliac intraarticular injection using the upper one-third joint technique is recommended for injections that are difficult with the lower one-third joint technique. OBJECTIVE: To evaluate the success rate of intraarticular sacroiliac joint (SIJ) injections using the upper and lower one-third joint techniques. STUDY DESIGN: Prospective randomized noninferiority study. SETTING: An interventional pain-management practice in a university hospital...
May 2018: Pain Physician
https://www.readbyqxmd.com/read/29690728/-efficacy-of-yisaipu-tapering-in-the-treatment-of-ankylosing-spondylitis
#2
Z X Huang, X Q Guo, W M Deng, S L Zheng, X Guo, Y K Huang, T W Li
Objective: To assess the efficacy of Yisaipu tapering in patients with ankylosing spondylitis (AS). Methods: A total of 87 cases of AS patients from Guangdong Second Provincial General Hospital who were treated with Yisaipu and celecoxib were retrospectively analyzed from February 2013 to April 2017.All patients received full dose Yisaipu and celecoxib in the initial 12 weeks.After that, the patients in the full dose group maintained Yisaipu (50 mg/w) treatment from the 13(rd) to 24(th) week, while tapering group received Yisaipu 50 mg subcutaneous injection once every other week...
April 17, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29665824/inflammatory-back-pain-in-psoriatic-arthritis-is-significantly-more-responsive-to-corticosteroids-compared-to-back-pain-in-ankylosing-spondylitis-a-prospective-open-labelled-controlled-pilot-study
#3
Muhammad Haroon, Muddassar Ahmad, Muhammad Nouman Baig, Olivia Mason, John Rice, Oliver FitzGerald
BACKGROUND: The efficacy of corticosteroids in patients with psoriatic arthritis (PsA) and inflammatory back pain has not been studied to date. In this controlled trial, we aimed to investigate the comparative performance of corticosteroids in patients with active axial-PsA (AxPsA) versus those with active ankylosing spondylitis (AS). METHODS: Patients with AxPsA and AS (naïve to biologic therapies), who not only had clinically active disease, but also had bone marrow oedema on magnetic resonance imaging of the sacroiliac joints, were recruited...
April 17, 2018: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29609940/functional-outcome-from-sacroiliac-joint-prolotherapy-in-patients-with-sacroiliac-joint-instability
#4
Martin D Hoffman, Vikram Agnish
OBJECTIVES: Examine the effectiveness of sacroiliac (SI) joint prolotherapy for SI joint instability, and characterize the patients most likely to benefit from this treatment. DESIGN: Retrospective cohort study. SETTING: Department of Veterans Affairs outpatient physical medicine clinic. INTERVENTIONS: Patients referred for low back pain and diagnosed with SI joint instability received a series of three SI joint prolotherapy injections (15% dextrose in lidocaine) at approximately a one-month interval...
April 2018: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/29357334/sacroiliac-joint-intraarticular-injection-in-true-anteroposterior-view-description-of-a-new-c-arm-guided-method
#5
Arman Taheri, Mahbod Lajevardi, Mohsen Abad, Jayran Zebardast, Sanaz Shaabani
BACKGROUND: The anatomic characteristics of the sacroiliac joint (SIJ) make it difficult to achieve intraarticular injection without radiologic guidance. The classic C-arm guided SIJ intervention technique is difficult. Here we describe a new and simple method for SIJ intraarticular intervention. OBJECTIVE: This study aims to introduce a new, simple approach for SIJ intraarticular intervention. STUDY DESIGN: An observational case series study...
January 2018: Pain Physician
https://www.readbyqxmd.com/read/29306764/treatment-strategy-for-sacroiliac-joint-related-pain-at-or-around-the-posterior-superior-iliac-spine
#6
Eiichi Murakami, Daisuke Kurosawa, Toshimi Aizawa
OBJECTIVE: Pain at or around the posterior superior iliac spine (PSIS) is characteristic of sacroiliac joint (SIJ) -related pain. This pain can be treated by either a peri- or intra-articular injection into the joint, with the former being much easier to perform. We investigated whether peri- or intra-articular injections were more frequently effective in patients with SIJ-related pain, and aimed to create an efficient treatment strategy for SIJ-related pain at or around the PSIS. DESIGN: Prospective case-control study...
February 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29203308/magnetic-resonance-imaging-undetectable-epiduroscopic-hotspot-in-chronic-diskogenic-back-pain-does-sinuvertebral-neuropathy-actually-exist
#7
Sung Ho Choi, Nitin Adsul, Hyeun Sung Kim, Jee-Soo Jang, Il-Tae Jang, Seong-Hoon Oh
BACKGROUND: The causes of chronic diskogenic back pain have not yet been clearly identified. Neural ingrowth around the annulus is widely considered to be one of the possible cause. However, neuropathy around the annulus has yet to be observed visually. We report a case of a hotspot that was observed in an epiduroscopic view, but not in imaging findings. CASE DESCRIPTION: A 46-year-old woman was admitted with pain in the back, left buttock, and posterior thigh for 2 years...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29173661/sacroiliac-joint-interventions
#8
REVIEW
David A Soto Quijano, Eduardo Otero Loperena
Sacroiliac joint (SIJ) pain is an important cause of lower back problems. Multiple SIJ injection techniques have been proposed over the years to help in the diagnosis and treatment of this condition. However, the SIJ innervation is complex and variable, and truly intra-articular injections are sometimes difficult to obtain. Different sacroiliac joint injections have shown to provide pain relief in patients suffering this ailment. Various techniques for intraarticular injections, sacral branch blocks and radiofrequency ablation, both fluoroscopy guided and ultrasound guided are discussed in this paper...
February 2018: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29149139/reversal-of-growth-of-utilization-of-interventional-techniques-in-managing-chronic-pain-in-medicare-population-post-affordable-care-act
#9
Laxmaiah Manchikanti, Amol Soin, Dharam P Mann, Sanjay Bakshi, Vidyasagar Pampati, Joshua A Hirsch
BACKGROUND: Over the past 2 decades, the increase in the utilization of interventional techniques has been a cause for concern. Despite multiple regulations to reduce utilization of interventional techniques, growth patterns continued through 2009. A declining trend was observed in a previous evaluation; however, a comparative analysis of utilization patterns of interventional techniques has not been performed showing utilization before and after the enactment of the Affordable Care Act (ACA)...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29092085/appropriate-use-criteria-for-fluoroscopically-guided-diagnostic-and-therapeutic-sacroiliac-interventions-results-from-the-spine-intervention-society-convened-multispecialty-collaborative
#10
John MacVicar, D Scott Kreiner, Belinda Duszynski, David J Kennedy
Objective: To provide an overview of a multisociety effort to formulate appropriate use criteria for image-guided injections and radiofrequency procedures in the diagnosis and treatment of sacroiliac joint and posterior sacroiliac complex pain. Methods: The Spine Intervention Society convened a multisociety effort to guide physicians and define for payers the appropriate use of image-guided injections and radiofrequency procedures. An evidence panel was established to write systematic reviews, define key terms and assumptions, and develop clinical scenarios to be addressed...
November 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29067775/dual-phase-hybrid-18-f-fluoride-positron-emission-tomography-mri-in-ankylosing-spondylitis-investigating-the-link-between-mri-bone-changes-regional-hyperaemia-and-increased-osteoblastic-activity
#11
Lino M Sawicki, Susanne Lütje, Xenofon Baraliakos, Jürgen Braun, Julian Kirchner, Johannes Boos, Philipp Heusch, Verena Ruhlmann, Ken Herrmann, Lale Umutlu, Harald H Quick, Gerald Antoch, Christian Buchbender
INTRODUCTION: Focal (18) F-Fluoride uptake on blood-pool phase PET represents regional hyperaemia, while it indicates osteoblastic activity on mineralization phase PET. This study investigates the link between regional hyperaemia and osteoblastic activity in inflammatory and chronic lesions of ankylosing spondylitis (AS) of the sacroiliac joints (SIJ) using dual-phase (18) F-Fluoride PET/MRI. METHODS: Thirteen patients (six men, seven women, age: 37 ± 10 years) with active AS prospectively underwent dual-phase (18) F-Fluoride PET/MRI...
October 25, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28983677/reduced-dose-c-arm-computed-tomography-applications-at-a-pediatric-institution
#12
Michael Acord, Sphoorti Shellikeri, Seth Vatsky, Abhay Srinivasan, Ganesh Krishnamurthy, Marc S Keller, Anne Marie Cahill
BACKGROUND: Reduced-dose C-arm computed tomography (CT) uses flat-panel detectors to acquire real-time 3-D images in the interventional radiology suite to assist with anatomical localization and procedure planning. OBJECTIVE: To describe dose-reduction techniques for C-arm CT at a pediatric institution and to provide guidance for implementation. MATERIALS AND METHODS: We conducted a 5-year retrospective study on procedures using an institution-specific reduced-dose protocol: 5 or 8 s Dyna Rotation, 248/396 projection images/acquisition and 0...
December 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28902756/sacroiliac-joint-dysfunction-in-the-athlete-diagnosis-and-management
#13
REVIEW
Rebecca Peebles, Christopher E Jonas
Sacroiliac joint (SIJ) dysfunction is a common cause of low back pain in the athlete, especially in sports with repetitive, asymmetric loading. Complex anatomy and broad pain referral pattern make diagnosis difficult. Identifying three or more positive physical examination maneuvers for the SIJ improves examination sensitivity and specificity. Imaging is rarely helpful in establishing the diagnosis but is often used to rule out other pathology. Conservative management with activity modification, medication, physical therapy, manipulation and bracing is first line treatment...
September 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/28676368/interventional-management-for-pelvic-pain
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
February 1, 2018: 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
#20
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...
2017: Gynecologic and Obstetric Investigation
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