Anesthesiology and Pain Management, Cairo University, Cairo, Egypt.
Pain Pract. 2021 Apr;21(4):404-410. doi: 10.1111/papr.12967. Epub 2020 Dec 1.
The sacroiliac joint is one of the most common sources of low back pain; however, it is difficult to place the needle accurately inside the joint space without image guidance. Improvement of ultrasound technology may lead to a high success rate for intra-articular drug deposition.
Assessment of the success rate of ultrasound-guided intra-articular sacroiliac joint injection.
Prospective observational study.
Ultrasound-guided injections were performed on 34 patients suffering from sacroiliitis. After injection of the drug solution and withdrawal of the needle, an anteroposterior fluoroscopy image was obtained and recorded for the injected joint to detect whether it was predominantly intra-articular or peri-articular. Clinical outcome using a numeric pain rating scale as well as limitation of physical functioning measured by the Oswestry Disability Index (ODI) were determined.
Thirty-three injections (84.6%) were intra-articular, while 6 injections (15.4%) were peri-articular, as confirmed by fluoroscopy, with no statistical difference regarding clinical outcome between them. The baseline mean pain score decreased from 7.21 to 1.92 1 month after injection, and the mean ODI scores improved from 61.41% to 17.13%. Intervention was well tolerated, and 91.2% of patients were satisfied or mostly satisfied.
Ultrasonography provides a high success rate of intra-articular sacroiliac joint injection as confirmed by fluoroscopy. No significant difference in clinical outcome between intra-articular and peri-articular injection was found.
骶髂关节是导致下腰痛的最常见原因之一；然而，如果没有影像学引导，很难将针准确地置入关节间隙内。超声技术的改进可能会提高关节内药物沉积的成功率。
评估超声引导下骶髂关节内注射的成功率。
前瞻性观察研究。
对 34 例患有骶髂关节炎的患者进行超声引导下注射。注射药物溶液并拔出针头后，进行前后位透视检查，并记录注射关节的图像，以确定注射部位是主要在关节内还是关节周围。使用数字疼痛评分量表评估临床疗效，用 Oswestry 残疾指数（ODI）评估躯体功能受限情况。
33 次注射（84.6%）为关节内注射，6 次注射（15.4%）为关节周围注射，透视检查证实了这一点，但两种注射方法的临床疗效无统计学差异。基线时平均疼痛评分从 7.21 分降至注射后 1 个月的 1.92 分，平均 ODI 评分从 61.41%降至 17.13%。干预措施耐受性良好，91.2%的患者满意或非常满意。
超声检查可提供高成功率的骶髂关节内注射，透视检查结果证实了这一点。关节内和关节周围注射的临床疗效无显著差异。
