Ultrasound-Guided Versus Fluoroscopy-Guided Sacroiliac Joint Intra-articular Injections in the Noninflammatory Sacroiliac Joint Dysfunction: A Prospective, Randomized, Single-Blinded Study

Jee, Haemi; Lee, Ji-Hae; Park, Ki Deok; Ahn, Jaeki; Park, Yongbum

doi:10.1016/j.apmr.2013.09.021

Cited by 89 publications

(74 citation statements)

References 30 publications

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“…Both groups demonstrated significant reduction in pain scores and decrease in disability as measured by the Oswestry disability index. There was also no significant difference between the US-guided and FS groups in terms of pain relief experienced by patients and overall satisfaction [58]. Particular utility may be associated with use of US for SI joint injections in children [59].…”

Section: • Sacroiliac Joint Injectionsmentioning

confidence: 81%

“…They were able to show that despite placing the needle intra-articularly <50% of the time, there were no significant differences in clinical outcome in their cohort. Similarly, Jee et al [58] published a prospective, randomized single-blinded study that evaluated the efficacy of US-versus FS-guided intra-articular injections into the SI joint over a period of 12 weeks in 120 patients. In the US group, intra-articular needle placement was successful in 87.3% of patients as compared with 98.2% in the FS group [58].…”

Section: • Sacroiliac Joint Injectionsmentioning

confidence: 99%

“…Similarly, Jee et al [58] published a prospective, randomized single-blinded study that evaluated the efficacy of US-versus FS-guided intra-articular injections into the SI joint over a period of 12 weeks in 120 patients. In the US group, intra-articular needle placement was successful in 87.3% of patients as compared with 98.2% in the FS group [58]. Both groups demonstrated significant reduction in pain scores and decrease in disability as measured by the Oswestry disability index.…”

Section: • Sacroiliac Joint Injectionsmentioning

confidence: 99%

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Ultrasound-Guided Interventional Procedures for Chronic Pain Management

et al. 2015

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Ultrasonography has multiple advantages over traditional radiologic imaging modalities when used for interventional procedures. It allows improved visualization of the anatomy while avoiding ionizing radiation and risks associated with contrast use. It has proved superiority at accuracy of delivery and procedural effectiveness over blind procedures when used in association with interventional pain procedures. Although limited in its ability to see through bony structures, ultrasound has utility in visualizing soft tissues and vascular structures in anatomic regions of interest resulting in increased use for posterior neuraxial, periaxial, peripheral nerve and joint-related structures. Current evidence for use in these settings is presented here. In some cases, optimal utility may be improved by combining ultrasonography with other imaging modalities. KEYWORDS• chronic pain management Advantages of ultrasound imagingInterventional pain procedures were traditionally performed under fluoroscopic (FS), computed tomography (CT) or MRI guidance. The use of ultrasound (US) to perform injections for chronic pain has significantly increased in the past decade [1,2]. This increase is attributed to its multiple advantages over other imaging modalities including ease of performance, absence of ionizing radiation, better visualization of soft tissue (i.e., muscle, ligament) and blood vessels, real time visualization of needle advancement and, at times, the ability to observe the spread of injectate [3]. US Practice points• Use of ultrasound in medicine has grown with smaller size equipment, increased portability and decreased cost.• Ultrasound has multiple advantages over radiographic imaging when used for interventional pain procedures.• Sonography is useful for medial branch blocks and intra-articular facet blocks in the cervical and lumbar spine but there is little evidence to support its use in the thoracic spine.• Ultrasonography is limited in utility for many types of axial injections because of bony and acoustic shadowing artifact but it does show some promise with transforaminal epidurals or selective nerve root blocks.• Ultrasound guidance is effective in preventing soft tissue and vascular injury in stellate ganglion blocks compared with blind techniques. Soft tissue and vascular anomalies can be identified that fluoroscopic technique will miss.• Ultrasound improves accuracy and efficacy in ilioinguinal, iliohypogastric and genitofemoral blocks for inguinal and testicular pain.• Lateral femoral cutaneous nerve injections are more accurate under ultrasound guidance, especially given the anatomic variation the nerve exhibits in cadaver dissections.• Injections into the knee, shoulder and hip joints are more successful when performed using ultrasound.For reprint orders, please contact: reprints@futuremedicine.com

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Section: • Sacroiliac Joint Injectionsmentioning

confidence: 81%

Section: • Sacroiliac Joint Injectionsmentioning

confidence: 99%

Section: • Sacroiliac Joint Injectionsmentioning

confidence: 99%

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Ultrasound-Guided Interventional Procedures for Chronic Pain Management

et al. 2015

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“…In a randomized prospective study by Jee and colleagues, fluoroscopy was compared to ultrasound guidance for SIJ injection (n = 110). Successful intra‐articular needle placement was reported in 98% of fluoroscopically guided injections as compared to 87% of ultrasound‐guided injections . The placement was verified to be intra‐articular and not intravascular by subsequent fluoroscopic evaluation.…”

Section: Summary Of the Published Literaturementioning

confidence: 96%

“…When confirming intra‐articular needle placement by contrast flow, the authors found ultrasound and fluoroscopic guidance to be successful 50% and 65% of the time, respectively. Similarly, Lee et al completed a prospective randomized controlled trial (RCT) with 120 subjects using either fluoroscopy or ultrasound guidance and found no difference in functional outcome or pain reduction between groups . Even more interesting is that in another prospective RCT on 125 subjects, Cohen et al found only a modest improvement in pain reduction using fluoroscopy‐guided vs anatomic palpation guidance .…”

Section: Summary Of the Published Literaturementioning

confidence: 99%

Image‐Guided Sacroiliac Joint Injections: an Evidence‐based Review of Best Practices and Clinical Outcomes

Zheng

Schneider

Yang

et al. 2019

PM&R

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Injections into the intraarticular sacroiliac joint (SIJ) are commonly done for both diagnostic and therapeutic reasons. Injection of an anesthetic can aid in the diagnosis of SIJ pain. Corticosteroids can be administered with the goal of providing a therapeutic effect. This article summarizes the literature regarding the diagnostic and therapeutic effects of these injections. It includes a review of the various imaging modalities including fluoroscopy, ultrasound, and computed tomography guidance, as well as a discussion on the prevalence data and other variables that may affect the reported outcomes.

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Ultrasound‐guided interventions during pregnancy for lumbosacral pain unresponsive to conservative treatment: A retrospective review

Comlek

2020

J of Clinical Ultrasound

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Purpose: Current conventional therapeutic strategies for lumbosacral pain during pregnancy are usually inadequate and data regarding interventional analgesic procedures feasible in pregnant women is scarce. We decided to retrospectively review our experience of ultrasound-guided pain management procedures in pregnant women with lumbosacral pain unresponsive to conservative treatment. Methods: Twenty women in the second trimester of pregnancy with lumbosacral pain developed during pregnancy unresponsive to conservative treatments who underwent the following ultrasound-guided pain interventions were included: sacroiliac joint, caudal epidural, interlaminar epidural, and trigger point injections. All patients were followed up until early postnatal period using Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores. Results: All but one patient achieved satisfactory pain control throughout the pregnancy with a single injection. Significant declines in ODI and VAS scores was attained within the first 2 weeks and first week of intervention, respectively, which was maintained thereafter until early postnatal period. Conclusions: Injections used for effective interventional pain management in nonpregnant populations seem to represent an effective and safe method also for pregnant women when performed under ultrasound guidance, with rapid onset and enduring duration of action until the time of delivery.

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Ultrasound-Guided Versus Fluoroscopy-Guided Sacroiliac Joint Intra-articular Injections in the Noninflammatory Sacroiliac Joint Dysfunction: A Prospective, Randomized, Single-Blinded Study

Cited by 89 publications

References 30 publications

Ultrasound-Guided Interventional Procedures for Chronic Pain Management

Ultrasound-Guided Interventional Procedures for Chronic Pain Management

Image‐Guided Sacroiliac Joint Injections: an Evidence‐based Review of Best Practices and Clinical Outcomes

Ultrasound‐guided interventions during pregnancy for lumbosacral pain unresponsive to conservative treatment: A retrospective review

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