Dawson P U, Rose R E, Wade N A
Physical Medicine and Rehabilitation, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica, West Indies.
Division of Orthopaedics, Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston 7, Jamaica, West Indies.
West Indian Med J. 2015 Sep;64(4):432-4. doi: 10.7727/wimj.2014.179. Epub 2015 May 4.
Osteogenesis imperfecta, also known as 'brittle bone disease', is a genetic connective tissue disease. It is characterized by bone fragility and osteopenia (low bone density). In this case, a 57-year old female presented to the University Hospital of the West Indies (UHWI), Physical Medicine and Rehabilitation Clinic with left low back pain rated 6/10 on the numeric rating scale (NRS). Clinically, the patient had sacroiliac joint mediated pain although X-rays did not show the sacroiliac joint changes. Fluoroscopy-guided left sacroiliac joint steroid injection was done.
Numeric rating scale and Oswestry Disability Index (ODI) questionnaire were used to evaluate outcome. This was completed at baseline, one week follow-up and at eight weeks post fluoroscopy-guided sacroiliac joint steroid injection.
Numeric rating scale improved from 6/10 before the procedure to 0/10 post procedure, and ODI questionnaire score improved from a moderate disability score of 40% to a minimal disability score of 13%. Up to eight weeks, the NRS was 0/10 and ODI remained at minimal disability of 15%.
Fluoroscopy-guided sacroiliac joint injection is a known diagnostic and treatment method for sacroiliac joint mediated pain. To our knowledge, this is the first case published on the use of fluoroscopy-guided sacroiliac joint steroid injection in the treatment of sacroiliac joint mediated low back pain in a patient with osteogenesis imperfecta.
成骨不全症，也被称为“脆骨病”，是一种遗传性结缔组织疾病。其特征为骨质脆弱和骨质减少（骨密度低）。在本病例中，一名57岁女性因左腰背痛就诊于西印度群岛大学医院（UHWI）物理医学与康复诊所，疼痛在数字评分量表（NRS）上评分为6/10。临床上，患者存在骶髂关节介导的疼痛，尽管X线检查未显示骶髂关节改变。遂进行了透视引导下左骶髂关节类固醇注射。
使用数字评分量表和奥斯威斯利功能障碍指数（ODI）问卷评估结果。在基线、透视引导下骶髂关节类固醇注射后1周随访及8周时完成评估。
数字评分量表评分从治疗前的6/10改善至治疗后的0/10，ODI问卷评分从中度功能障碍评分40%改善至轻度功能障碍评分13%。直至8周时，NRS评分为0/10，ODI仍维持在轻度功能障碍的15%。
透视引导下骶髂关节注射是一种已知的用于诊断和治疗骶髂关节介导疼痛的方法。据我们所知，这是首例发表的关于在一名成骨不全症患者中使用透视引导下骶髂关节类固醇注射治疗骶髂关节介导的下腰痛的病例。
