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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2021; 62(02): e143-e152
DOI: 10.1055/s-0041-1728741
DOI: 10.1055/s-0041-1728741
Review Article | Artículo de Revisión
Sacroiliac Joint Pain: An Updated Review of the Clinical Approach for Diagnosis
Article in several languages: español | English
Abstract
Sacroiliac pain accounts for 15% to 30% of low back pain conditions. Its diagnosis is a challenge for the physician due to its complex anatomy, the wide differential diagnoses list, and its several causes. Diagnosis requires a structured clinical history and an accurate physical examination. Specific sacroiliac physical examination tests should be performed in patients with suspected sacroiliac joint pain and interpreted together, not in isolation. Magnetic resonance imaging can rule out other causes of low back pain or diagnose inflammatory sacroiliitis. Joint infiltration is the gold standard for diagnosis, and it should be performed in patients with a high suspicion of sacroiliac joint pain based on anamnesis, physical examination, and three or more positive specific sacroiliac tests.
Publication History
Received: 02 September 2020
Accepted: 21 January 2021
Article published online:
22 June 2021
© 2021. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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Referencías
- 1 Miranda J, Quezada P, Caballero P. et al. Revisión Sistemática: Epidemiología de Dolor Crónico No Oncológico en Chile. El Dolor. 2013; 59: 10-17
- 2 Bilbeny N. Dolor Crónico en Chile. Rev Med Clin Las Condes 2019; 30: 397-406
- 3 Diaz-Ledezma C, Urrutia J, Romeo J, Chelen A, González-Wilhelm L, Lavarello C. Factors associated with variability in length of sick leave because of acute low back pain in Chile. Spine J 2009; 9 (12) 1010-1015
- 4 Sembrano JN, Polly Jr DW. How often is low back pain not coming from the back?. Spine 2009; 34 (01) E27-E32
- 5 Cher D, Polly D, Berven S. Sacroiliac joint pain: burden of disease. Med Devices (Auckl) 2014; 7: 73-81
- 6 Weksler N, Velan GJ, Semionov M. et al. The role of sacroiliac joint dysfunction in the genesis of low back pain: the obvious is not always right. Arch Orthop Trauma Surg 2007; 127 (10) 885-888
- 7 Dreyfuss P, Michaelsen M, Pauza K, McLarty J, Bogduk N. The value of medical history and physical examination in diagnosing sacroiliac joint pain. Spine 1996; 21 (22) 2594-2602
- 8 Fortin JD, Dwyer AP, West S, Pier J. Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part I: Asymptomatic volunteers. Spine 1994; 19 (13) 1475-1482
- 9 Fortin JD, Aprill CN, Ponthieux B, Pier J. Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part II: Clinical evaluation. Spine 1994; 19 (13) 1483-1489
- 10 Laslett M, Aprill CN, McDonald B, Young SB. Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Man Ther 2005; 10 (03) 207-218
- 11 Dreyfuss P, Cole AJ, Pauza K. Sacroiliac Joint Injection Techniques. Phys Med Rehabil Clin N Am 1995; 6: 785-813
- 12 Fortin JD, Falco FJ. The Fortin finger test: an indicator of sacroiliac pain. Am J Orthop 1997; 26 (07) 477-480
- 13 Kokmeyer DJ, Van der Wurff P, Aufdemkampe G, Fickenscher TCM. The reliability of multitest regimens with sacroiliac pain provocation tests. J Manipulative Physiol Ther 2002; 25 (01) 42-48
- 14 Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 1990; 72 (03) 403-408
- 15 Campos-Correia D, Sudoł-Szopińska I, Diana Afonso P. Are We Overcalling Sacroillitis on MRI? Differential diagnosis that every rheumatologist should know – Part II. Acta Reumatol Port 2019; 44 (01) 42-56
- 16 Puhakka KB, Melsen F, Jurik AG, Boel LW, Vesterby A, Egund N. MR imaging of the normal sacroiliac joint with correlation to histology. Skeletal Radiol 2004; 33 (01) 15-28
- 17 Vleeming A, Schuenke MD, Masi AT, Carreiro JE, Danneels L, Willard FH. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat 2012; 221 (06) 537-567
- 18 Fortin JD, Tolchin RB. Sacroiliac arthrograms and post-arthrography computerized tomography. Pain Physician 2003; 6 (03) 287-290
- 19 Ares JDA, Amatriaín GR, González AP, Nieto C. Bloqueo y radiofrecuencia de la articulación sacroilíaca. Rev Soc Esp Dolor. 2012; 19: 335-345
- 20 Le Huec JC, Tsoupras A, Leglise A, Heraudet P, Celarier G, Sturresson B. The sacro-iliac joint: A potentially painful enigma. Update on the diagnosis and treatment of pain from micro-trauma. Orthop Traumatol Surg Res 2019; 105 (1S): S31-S42
- 21 Kiapour A, Joukar A, Elgafy H, Erbulut DU, Agarwal AK, Goel VK. Biomechanics of the Sacroiliac Joint: Anatomy, Function, Biomechanics, Sexual Dimorphism, and Causes of Pain. Int J Spine Surg 2020; 14 (Suppl. 01) 3-13
- 22 Simons DG, Travell JG. Myofascial origins of low back pain. 1. Principles of diagnosis and treatment. Postgrad Med 1983; 73 (02) 66-77 , 68–70, 73 passim
- 23 Molina M, Campos M, Delgado M. Lumbago: Revisión actualizada del diagnóstico, tratamiento y pronóstico. Rev Chil Ortop Traumatol. 2014; 55: 113-125
- 24 Thawrani DP, Agabegi SS, Asghar F. Diagnosing Sacroiliac Joint Pain. J Am Acad Orthop Surg 2019; 27 (03) 85-93
- 25 Mitra R. Osteitis Condensans Ilii. Rheumatol Int 2010; 30 (03) 293-296
- 26 Ha K-Y, Lee J-S, Kim K-W. Degeneration of sacroiliac joint after instrumented lumbar or lumbosacral fusion: a prospective cohort study over five-year follow-up. Spine 2008; 33 (11) 1192-1198
- 27 Faundez AA, Richards J, Maxy P, Price R, Léglise A, Le Huec J-C. The mechanism in junctional failure of thoraco-lumbar fusions. Part II: Analysis of a series of PJK after thoraco-lumbar fusion to determine parameters allowing to predict the risk of junctional breakdown. Eur Spine J 2018; 27 (Suppl. 01) 139-148
- 28 Charles YP, Yu B, Steib J-P. Sacroiliac joint luxation after pedicle subtraction osteotomy: report of two cases and analysis of failure mechanism. Eur Spine J 2016; 25 (Suppl. 01) 63-74
- 29 Pozo P. Enfermedades reumatológicas más frecuentes en atención primaria: Espondiloartritis. En: Pacheco D. editor. Reumatología para médicos de Atención Primaria. Segunda edición.. Chile: Tangram Ediciones; 2015: 167-180
- 30 Slipman CW, Jackson HB, Lipetz JS, Chan KT, Lenrow D, Vresilovic EJ. Sacroiliac Joint Pain Referral Zones. 2000; 81: 334-338
- 31 Ou-Yang DC, York PJ, Kleck CJ, Patel VV. Diagnosis and Management of Sacroiliac Joint Dysfunction. J Bone Joint Surg Am 2017; 99 (23) 2027-2036
- 32 Correa-Illanes G. Dolor sacroilíaco: Epidemiología, fisiopatología, diagnóstico y tratamiento. Rehabil Integral. 2019; 14: 91-101
- 33 Martin RL, Sekiya JK. The interrater reliability of 4 clinical tests used to assess individuals with musculoskeletal hip pain. J Orthop Sports Phys Ther 2008; 38 (02) 71-77
- 34 Robinson HS, Brox JI, Robinson R, Bjelland E, Solem S, Telje T. The reliability of selected motion- and pain provocation tests for the sacroiliac joint. Man Ther 2007; 12 (01) 72-79
- 35 Werner CML, Hoch A, Gautier L, König MA, Simmen H-P, Osterhoff G. Distraction test of the posterior superior iliac spine (PSIS) in the diagnosis of sacroiliac joint arthropathy. BMC Surg 2013; 13: 52-57
- 36 Stuber KJ. Specificity, sensitivity, and predictive values of clinical tests of the sacroiliac joint: a systematic review of the literature. J Can Chiropr Assoc 2007; 51 (01) 30-41
- 37 van der Wurff P, Buijs EJ, Groen GJ. A multitest regimen of pain provocation tests as an aid to reduce unnecessary minimally invasive sacroiliac joint procedures. Arch Phys Med Rehabil 2006; 87 (01) 10-14
- 38 Eno J-JT, Boone CR, Bellino MJ, Bishop JA. The prevalence of sacroiliac joint degeneration in asymptomatic adults. J Bone Joint Surg Am 2015; 97 (11) 932-936
- 39
Poddubnyy D,
Gaydukova I,
Hermann K-G.
et al.
Magnetic resonance imaging compared to conventional radiographs for detection of chronic
structural changes in sacroiliac joints in axial spondyloarthritis. J Rheumatol 2013;
40 (09) 1557-1565
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- 40 Zilber K, Gorenberg M, Rimar D. et al. Radionuclide Methods in the Diagnosis of Sacroiliitis in Patients with Spondyloarthritis: An Update. Rambam Maimonides Med J 2016; 7 (04) e0037
- 41 Maigne JY, Boulahdour H, Chatellier G. Value of quantitative radionuclide bone scanning in the diagnosis of sacroiliac joint syndrome in 32 patients with low back pain. Eur Spine J 1998; 7 (04) 328-331
- 42 Rupert MP, Lee M, Manchikanti L, Datta S, Cohen SP. Evaluation of sacroiliac joint interventions: a systematic appraisal of the literature. Pain Physician 2009; 12 (02) 399-418
- 43 Manchikanti L, Hansen H, Pampati V, Falco FJE. Utilization and growth patterns of sacroiliac joint injections from 2000 to 2011 in the medicare population. Pain Physician 2013; 16 (04) E379-E390
- 44 Rosenberg JM, Quint TJ, de Rosayro AM. Computerized tomographic localization of clinically-guided sacroiliac joint injections. Clin J Pain 2000; 16 (01) 18-21
- 45 Schwartz A, Zlomislic V, Reckling WC, Cher D. Sacroiliac Joint Pain: Pathophysiology and Diagnosis. En: Rothman RH, Simeone FA, Herkowitz HN. editores. Rothman-Simeone and Herkowitz's, The Spine. Seventh edition.. Philadelphia, PA: Elsevier; 2018: 383-396
- 46 Polly Jr DW. The Sacroiliac Joint. Neurosurg Clin N Am 2017; 28 (03) 301-312
- 47 Simopoulos TT, Manchikanti L, Singh V. et al. A systematic evaluation of prevalence and diagnostic accuracy of sacroiliac joint interventions. Pain Physician 2012; 15 (03) E305-E344
- 48 Potter NA, Rothstein JM. Intertester reliability for selected clinical tests of the sacroiliac joint. Phys Ther 1985; 65 (11) 1671-1675
- 49 van der Wurff P, Hagmeijer RH, Meyne W. Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: Reliability. Man Ther 2000; 5 (01) 30-36
- 50 Berthelot J-M, Labat J-J, Le Goff B, Gouin F, Maugars Y. Provocative sacroiliac joint maneuvers and sacroiliac joint block are unreliable for diagnosing sacroiliac joint pain. Joint Bone Spine 2006; 73 (01) 17-23
- 51 Young S, Aprill C, Laslett M. Correlation of clinical examination characteristics with three sources of chronic low back pain. Spine J 2003; 3 (06) 460-465