Pain patterns originating from the sacroiliac joints

Fukui, Sei; Nosaka, Shunsuke

doi:10.1007/s005400200033

Cited by 22 publications

(13 citation statements)

References 7 publications

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“…Pain patterns were recorded prior to injections of local anesthetic and steroid into 32 SIJs in 28 patients in a further study . The selected patients had experienced at least 80% relief from a previous injection into the joint capsule, pain in the SIJ region with or without referred pain, and reproduction of pain by Gaenslen's or Patrick's tests.…”

Section: Resultsmentioning

confidence: 99%

“…In some studies, a positive response to these tests, most commonly to either one or three maneuvers, was a criterion that determined whether or not injections were performed and in some studies, provocation maneuvers were not performed .…”

Section: Resultsmentioning

confidence: 99%

“…Positive responders to injections can have somatic referred pain that radiates to the medial buttock and lower lumbar regions (69–72%), groin (9–14%), thigh (31–48%), and the greater trochanter (38%) .…”

Section: Discussionmentioning

confidence: 99%

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Fluoroscopically Guided Diagnostic and Therapeutic Intra-Articular Sacroiliac Joint Injections: A Systematic Review

Kennedy

Engel

Kreiner³

et al. 2015

Pain Med

102

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Objective. To assess the validity of fluoroscopically guided diagnostic intra-articular injections of local anesthetic and effectiveness of intra-articular steroid injections in treating sacroiliac joint (SIJ) pain.Design. Systematic review. Interventions.Ten reviewers independently assessed 45 publications on diagnostic validity or effectiveness of fluoroscopically guided intraarticular SIJ injections.Outcome Measures. For diagnostic injections, the primary outcome was validity; for therapeutic injections, analgesia. Secondary outcomes were also described.Results. Of 45 articles reviewed, 39 yielded diagnostic data on physical exam findings, provocation tests, and SIJ injections for diagnosing SIJ pain, and 15 addressed therapeutic effectiveness. When confirmed by comparative local anesthetic blocks with a high degree of pain relief, no single physical exam maneuver predicts response to diagnostic injections. When at least three physical exam findings are present, sensitivity, and specificity increases significantly. The prevalence of SIJ pain is likely 20-30% among patients that have suspected SIJ pain based on history and physical examination. This estimate may be higher in certain subgroups such as the elderly and fusion patients. Two randomized controlled trials and multiple observational studies supported the effectiveness of therapeutic sacroiliac joint injections.Conclusions. Based on this literature, it is unclear whether image-guided intra-articular diagnostic injections of local anesthetic predict positive responses to therapeutic agents. The overall quality of evidence is moderate for the effectiveness of therapeutic SIJ injections.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Fluoroscopically Guided Diagnostic and Therapeutic Intra-Articular Sacroiliac Joint Injections: A Systematic Review

Kennedy

Engel

Kreiner³

et al. 2015

Pain Med

102

View full text Add to dashboard Cite

show abstract

“…The Fortin area found in our study in responders is almost the same as the original area described by Fortin et al 9,10 as an area common to every individual, such that it is F 3 Â 10 cm in size and located just inferior to the PSIS. It also seems to be in keeping with the composite drawings of Dreyfuss et al 8 and Fukui and Nosaka, 12 although different methods were used.…”

Section: Discussionmentioning

confidence: 90%

“…10 Results of other studies 5,8,11 were similar to those of Fortin et al, 9,10 although they also put emphasis on the referral of SI joint pain to the leg. Composite drawings of pain referral areas to establish which area would be the referral area in all patients have been used before [8][9][10]12 but without a graded scale. In a recent study, 5 referral areas were only delineated descriptively.…”

mentioning

confidence: 99%