Waldman Leah E, Maluli Isabela, Moon Charles N, Skalski Matthew, Matcuk George R
Department of Radiology, Duke University Medical Center, Box 3808 DUMC, Durham, NC, 27710, USA.
Duke University, Durham, NC, USA.
Skeletal Radiol. 2025 Jun;54(6):1195-1213. doi: 10.1007/s00256-024-04831-z. Epub 2024 Nov 18.
The sacroiliac joints (SIJ) play a pivotal role in pelvic stability and load transmission. SIJ-related disorders can pose a diagnostic challenge because of complex anatomy, non-specific imaging findings, and overlapping symptomatology with other lower back conditions. Broadly, SIJ pathology can be divided into the following categories: infectious, inflammatory, degenerative, mechanical, traumatic, and neoplastic. On the spectrum of mechanical disorders is the entity of SIJ dysfunction, defined as pain localized to the SIJ due to non-inflammatory causes. This paper aims to enhance the understanding of SIJ dysfunction by exploring SIJ anatomy, pathophysiology, and differential diagnosis for SIJ pain. Etiologies, associations, and diagnostic physical examination maneuvers for SIJ dysfunction are reviewed. We will discuss the role of diagnostic imaging in SIJ dysfunction and propose imaging findings which may indicate the diagnosis. Finally, we will discuss therapeutic strategies to treat SIJ dysfunction. By delving into the complexities of SIJ anatomy and pathophysiology, this paper provides valuable discernment for the diagnosis and management of SIJ-related disorders.
骶髂关节（SIJ）在骨盆稳定性和负荷传递中起关键作用。由于解剖结构复杂、影像学表现不特异以及与其他下背部疾病症状重叠，骶髂关节相关疾病的诊断颇具挑战。广义而言，骶髂关节病理可分为以下几类：感染性、炎症性、退行性、机械性、创伤性和肿瘤性。骶髂关节功能障碍属于机械性疾病范畴，定义为因非炎症性原因导致的局限于骶髂关节的疼痛。本文旨在通过探讨骶髂关节解剖、病理生理学以及骶髂关节疼痛的鉴别诊断，加深对骶髂关节功能障碍的理解。综述了骶髂关节功能障碍的病因、关联因素及诊断性体格检查手法。我们将讨论诊断性影像学在骶髂关节功能障碍中的作用，并提出可能提示诊断的影像学表现。最后，我们将讨论治疗骶髂关节功能障碍的治疗策略。通过深入研究骶髂关节解剖和病理生理学的复杂性，本文为骶髂关节相关疾病的诊断和管理提供了有价值的见解。
