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Diagnosis and Management of Sacroiliac Joint Dysfunction

Ou-Yang, David C. MD1,a; York, Philip J. MD1,b; Kleck, Christopher J. MD1,c; Patel, Vikas V. MA, MD1,d

doi: 10.2106/JBJS.17.00245
Current Concepts Review

  • ➤ Symptoms that suggest that the sacroiliac joint (SIJ), as opposed to pathology of the lumbar spine or hip, may be a source of pain include pain with position changes, such as standing from a seated position or sitting on a hard surface. Radiation to the groin or Fortin area also suggest sacroiliac joint as a source.
  • ➤ A constellation of findings, including pain referral patterns, provocative maneuvers, and response to injections, should be utilized when assessing SIJ pathology.
  • ➤ While its effectiveness remains unsubstantiated, manipulation of the SIJ is noninvasive and warrants consideration as an initial treatment modality.
  • ➤ The diagnostic validity of local anesthetic and/or corticosteroid injections is difficult to assess as the criteria for a positive response are not uniform in the literature, and evidence to support intra-articular injections for therapeutic purposes is weak.
  • ➤ SIJ fusion appears to be emerging as an acceptable treatment for patients with recalcitrant SIJ dysfunction; however, only a few long-term outcome studies have been done.
  • ➤ New minimally invasive fusion techniques appear to decrease the morbidity of open procedures with at least comparable outcomes.

1Department of Orthopaedic Surgery, University of Colorado, Denver, Colorado

aE-mail address for D.C. Ou-Yang:

bE-mail address for P.J. York:

cE-mail address for C.J. Kleck:

dE-mail address for V.V. Patel:

Copyright © 2017 by The Journal of Bone and Joint Surgery, Incorporated
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