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Alice Ashouri Christiansen, Oliver Hendricks, Dorota Kuettel, Kim Hørslev-Petersen, Anne Grethe Jurik, Steen Nielsen, Kaspar Rufibach, Anne Gitte Loft, Susanne Juhl Pedersen, Louise Thuesen Hermansen, Mikkel Østergaard, Bodil Arnbak, Claus Manniche, Ulrich Weber
OBJECTIVE: To determine the reproducibility of evaluation of sacroiliac joint (SIJ) radiographs among readers with varying levels of experience, and to identify potential drivers of disagreement in classification among 5 predefined radiographic lesion types. METHODS: The study sample consisted of 104 consecutive patients aged 18-40 with low back pain ≥ 3 months of duration who met the Assessment of SpondyloArthritis international Society (ASAS) definition for a positive SIJ magnetic resonance imaging, or were HLA-B27-positive and had ≥ 1 spondyloarthritis (SpA)-related clinical/laboratory feature according to the ASAS classification criteria for axial SpA...
October 15, 2016: Journal of Rheumatology
Xenofon Baraliakos, Juergen Braun
Inflammatory and chronic structural changes are objective signs of axial spondyloarthritis. In the sacroiliac joints (SIJs), inflammation (sacroiliitis) can be visualized as bone marrow edema, whereas chronic structural changes are visualized as fat metaplasia, erosions, sclerosis, or ankylosis in the area of the SIJ. In the spine, bone marrow edema in the vertebral bodies represents spondylitis but can also affect the facet and the costovertebral and costotransverse joints (arthritis), whereas structural changes are visualized as fat metaplasia, sclerosis or syndesmophytes and ankylosis at the vertebral edges...
November 2016: Rheumatic Diseases Clinics of North America
Kyung Hee Do, Sang Ho Ahn, Rodney Jones, Sung Ho Jang, Su Min Son, Dong Gyu Lee, Hee Kyung Cho, Gyu Sik Choi, Yun-Woo Cho
OBJECTIVES: Sacroiliac joint (SIJ) injections have been used to provide short-term relief of SIJ pain. In this study, the authors investigated a new technique using a superior approach. METHODS: Twenty four patients with chronic SI joint paint were recruited. Each patient was treated with a single SIJ intra-articular injection plus a periarticular injection of local anesthetic and corticosteroid in one procedure. Technical accuracy of the intra-articular procedure was determined by having 2 independent observers review and rate the quality of arthrograms obtained...
October 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Bodil Arnbak, Rikke Krüger Jensen, Claus Manniche, Oliver Hendricks, Peter Kent, Anne Grethe Jurik, Tue Secher Jensen
BACKGROUND: The aim of this study was to investigate subgroups of magnetic resonance imaging (MRI) findings for the spine and sacroiliac joints (SIJs) using latent class analysis (LCA), and to investigate whether these subgroups differ in their demographic and clinical characteristics. METHODS: The sample included 1037 patients aged 18-40 years with persistent low back pain (LBP). LCA was applied to MRI findings of the spine and SIJs. The resulting subgroups were tested for differences in self-reported demographic and clinical characteristics...
October 13, 2016: Arthritis Research & Therapy
Varun Singla, Yatindra K Batra, Neerja Bharti, Vijay G Goni, Neelam Marwaha
BACKGROUND: Despite widespread use of steroids to treat sacroiliac joint (SIJ) pain, their duration of pain reduction is short. Platelet-rich plasma (PRP) can potentially enhance tissue healing and may have a longer-lasting effect on pain. OBJECTIVES: To assess the efficacy and safety of PRP compared with methylprednisolone in ultrasound-guided SIJ injection for low back pain. STUDY DESIGN: Prospective randomized open blinded end-point (PROBE) study...
September 27, 2016: Pain Practice: the Official Journal of World Institute of Pain
David W Polly, John Swofford, Peter G Whang, Clay J Frank, John A Glaser, Robert P Limoni, Daniel J Cher, Kathryn D Wine, Jonathan N Sembrano
BACKGROUND: Sacroiliac joint (SIJ) dysfunction is an important and underappreciated cause of chronic low back pain. OBJECTIVE: To prospectively and concurrently compare outcomes after surgical and non-surgical treatment for chronic SIJ dysfunction. METHODS: One hundred and forty-eight subjects with SIJ dysfunction were randomly assigned to minimally invasive SIJ fusion with triangular titanium implants (SIJF, n = 102) or non-surgical management (NSM, n = 46)...
2016: International Journal of Spine Surgery
Julius Dengler, Bengt Sturesson, Djaya Kools, Domenico Prestamburgo, Daniel Cher, Eddie van Eeckhoven, Emanuel Erk, Robert Pflugmacher, Peter Vajkoczy
BACKGROUND: The first results from the randomized, controlled iFuse Implant System Minimally Invasive Arthrodesis (iMIA) trial showed that minimally invasive surgical management (MISM) of low back pain originating from the sacroiliac joint (SIJ) by placing transarticular triangular titanium implants reduced pain more effectively than conservative management (CM). We now conducted a separate analysis of the iMIA data to assess whether the referred leg pain (RLP) component of SIJ-associated pain may also be affected by MISM or CM...
November 2016: Acta Neurochirurgica
Shushovan Chakrabortty, Sanjeev Kumar, Deepak Gupta, Sruthi Rudraraju
As many as 62% low back pain patients can have sacroiliac joint (SIJ) pain. There is limited (to poor) evidence in regards to long-term pain relief with therapeutic intra-articular injections and/or conventional (heat or pulsed) radiofrequency ablations (RFAs) for SIJ pain. We report our pain-clinic experience with peripheral nerve field stimulation (PNFS) for two patients of intractable SIJ pain. They had reported absence of long-term pain relief (pain relief >50% for at least 2 weeks postinjection and at least 3 months post-RFA) with SIJ injections and SIJ RFAs...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
M Lorenzin, A Ortolan, P Frallonardo, S Vio, C Lacognata, F Oliviero, L Punzi, R Ramonda
Our aim was to determine the prevalence of spine and sacroiliac joint (SIJ) lesions on magnetic resonance imaging (MRI) in patients with early axial spondyloarthritis (axSpA) and their correlation with disease activity indices. Sixty patients with low back pain (LBP) (≥3 months, ≤2 years, onset ≤45 years), attending the SpA-clinic of the Unità Operativa Complessa Reumatologia of Padova [SpondyloArthritis-Caught-Early (SPACE) study], were studied following a protocol including physical examination, questionnaires, laboratory tests, X-rays and spine and SIJ MRI...
2016: Reumatismo
Patrick J Polsunas, Gwendolyn Sowa, Julie M Fritz, Angela Gentili, Natalia E Morone, Srinivasa Naga Raja, Eric Rodriguez, Kenneth Schmader, Joel D Scholten, Debra K Weiner
OBJECTIVE: To present an algorithm of sequential treatment options for managing sacroiliac joint (SIJ) pain in the setting of chronic low back pain (CLBP) in the older adult. This is the tenth part in a series, and includes an illustrative clinical case. METHODS: The stepped care drug table and evaluation and treatment algorithm were created following a thorough literature review of approaches and subsequent analysis through a modified Delphi process. The principal investigator developed the initial draft, which was refined for content by an interdisciplinary panel of five experts...
September 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Sun-Kyoung You, Hyo-Jin Lee, Jeong-Eun Lee, Jongchul Kim, So-Mi Lee, Hyun-Hae Cho
OBJECTIVE: To assess the incidence of the sacroiliac joint vacuum phenomenon (SIJ VP) in paediatric patients and the relationship between the presence of VP and clinical factors such as age, sex and body mass index (BMI). METHODS: We retrospectively reviewed clinical data and imaging findings of 60 patients who underwent abdominopelvic CT (AP CT) between January and June 2015. Patients were divided into VP group and non-VP group based on the presence/absence of VP, and the groups were compared...
November 2016: British Journal of Radiology
T Finger, S Bayerl, M Bertog, M Czabanka, J Woitzik, P Vajkoczy
OBJECTIVE: We hypothesised, that the inclusion of the ilium for multilevel lumbosacral fusions reduces the incidence of postoperative sacroiliac joint (SIJ) pain. The primary objective of this study was to compare the frequency of postoperative SIJ pain in patients undergoing multilevel stabilization with and without sacropelvic fixation for multilevel degenerative spine disease. In addition, we aimed at identifying factors that may predict the worsening or new onset of postoperative SIJ pain...
November 2016: Clinical Neurology and Neurosurgery
Vinay S Anjana Reddy, Chhaya Sharma, Kuang-Yi Chang, Vivek Mehta
BACKGROUND: Sacroiliac joint (SIJ) pain is considered to be the third most common cause of low back pain with the prevalence of 13-25% in all low back pain patients. Its diagnosis and treatment remain a challenge with the poor evidence base for interventional procedures. Patients with SIJ pain experience a low quality of life, worse than some of the chronic health conditions. Simplicity radiofrequency (RF) neurotomy is a novel technique which tackles some of the problems faced by conventional RF neurotomy and may offer better results in managing pain arising from SIJ...
May 2016: British Journal of Pain
Kevin M Dube, Kristen L Ditch, Luanne Hills
Smoke inhalation injury (SIJ) is associated with an increase in morbidity and mortality in patients with burns. SIJ causes airway damage, inflammation, and bronchial obstruction, resulting in decreased oxygenation and perfusion status in these patients. Retrospective studies have compared the use of nebulized heparin (NH) plus nebulized N-acetylcysteine (NAC) and albuterol in patients with SIJ to those who received standard ventilator support with bronchodilator therapy. These studies are associated with a decrease in mortality when NH and nebulized NAC are administered to patients with SIJ...
August 16, 2016: Journal of Pharmacy Practice
Donald Sachs, Don Kovalsky, Andy Redmond, Robert Limoni, S Craig Meyer, Charles Harvey, Dimitriy Kondrashov
BACKGROUND: Sacroiliac joint (SIJ) fusion (SIJF), first performed 95 years ago, has become an increasingly accepted surgical option for chronic SIJ dysfunction. Few studies have reported intermediate- or long-term outcomes after SIJF. OBJECTIVE: The objective of this study is to determine patient-based outcomes after SIJF for chronic SIJ dysfunction due to degenerative sacroiliitis or SIJ disruption at ≥3 years of follow-up. METHODS: Consecutive patients who underwent SIJF prior to December 2012 were contacted over phone or through email...
2016: Medical Devices: Evidence and Research
Eyal Klang, Merav Lidar, Zvi Lidar, Dvora Aharoni, Iris Eshed
BACKGROUND: Computed tomography (CT) examinations of the lumbar spine are commonly performed in patients aged ≤40 years due to low back pain (LBP). PURPOSE: To investigate the prevalence and awareness of radiologists for the presence of structural post-inflammatory/other sacroiliac joint (SIJ) alterations on lumbar spine CTs of young patients with LBP. MATERIAL AND METHODS: A total of 484 lumbar spine CT examinations (272 men, 212 women; average age, 31 years; age range, 18-40 years) of patients with LBP in which the entire SIJs were visualized were retrospectively reviewed...
July 20, 2016: Acta Radiologica
Claire Bruna-Rosso, Pierre-Jean Arnoux, Rohan-Jean Bianco, Yves Godio-Raboutet, Léo Fradet, Carl-Éric Aubin
BACKGROUND: Sacroiliac joint (SIJ) is a known chronic pain-generator. The last resort of treatment is the arthrodesis. Different implants allow fixation of the joint, but to date there is no tool to analyze their influence on the SIJ biomechanics under physiological loads. The objective was to develop a computational model to biomechanically analyze different parameters of the stable SIJ fixation instrumentation. METHODS: A comprehensive finite element model (FEM) of the pelvis was built with detailed SIJ representation...
2016: International Journal of Spine Surgery
Timothy J P Bray, Thomas Amies, Kanimozhi Vendhan, Paul Humphries, Debajit Sen, Yiannis Ioannou, Margaret A Hall-Craggs
OBJECTIVE: To determine the extent to which inflammation of the sacroiliac joints (SIJs) and apophyseal joints (AJs) changes concordantly after treatment in enthesitis-related arthritis (ERA). METHODS: A retrospective study was performed with institutional review board approval. 31 young patients with ERA who had been scanned between March 2009 and November 2014 were included. All patients had post-contrast imaging of the SIJs and lumbar spine and short tau inversion-recovery (STIR) images of the SIJs...
September 2016: British Journal of Radiology
Keita Nishi, Kazunobu Saiki, Takeshi Imamura, Keishi Okamoto, Tetsuaki Wakebe, Keiko Ogami, Takashi Hasegawa, Takefumi Moriuchi, Junya Sakamoto, Yoshitaka Manabe, Toshiyuki Tsurumoto
The purpose of this study was to clarify the relevance of degenerative changes in the sacroiliac joint (SIJ) and the joints in the lower limb and lumbar spine using age estimation methods. We also examined the shape of the auricular surface to determine the effect of degenerative changes on each joint. A total of 200 iliac auricular surfaces from 100 Japanese male skeletons were examined macroscopically in accordance with conventional methods of age estimation. From the obtained estimated age, we calculated the deflection values, which represented the degree of degenerative changes of the joints...
June 24, 2016: Anatomical Science International
Marcus D Mazur, Mark A Mahan, Lubdha M Shah, Andrew T Dailey
BACKGROUND: S2-alar-iliac (S2AI) screws are 1 technique for lumbopelvic fixation to improve fusion rates across the lumbosacral junction that has gained wider acceptance. The S2AI screw crosses the cortical surfaces of the sacroiliac joint (SIJ), which may improve the biomechanical strength of the instrumentation. OBJECTIVE: To report preliminary radiographic outcomes of patients who underwent lumbopelvic fixation with S2AI screws with a minimum 12-month follow-up...
June 23, 2016: Neurosurgery
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