Background: Sacroiliac joint injection continues to play a role in the diagnosis and therapeutic management of patients with
sacroiliac joint arthropathy, as it provides pain relief and improvement in function to those patients. It is considered
a low-risk pain procedure with minimal to no adverse side effects. Although rare, serious com-plications such
as infection and hematoma are a possibility, however. In anticoagulated patients, interventional pain physicians
are advised to weigh the risks and benefits before discontinuing anticoagulation. The literature describes serious
complications associated with stopping anticoagulation, such as myocardial infarction. Howev-er, we should
also be mindful of the possibility of intramuscular hematoma formation in anticoagulated patients receiving
a fluoroscopically guided sacroiliac joint injection.
Case Report: This case exposes the development of a 300-mL hematoma in the right gluteus maximus muscle after a
fluoro-scopically guided sacroiliac joint injection in a patient who was taking warfarin. Consequently, she also
developed neurologic symptoms such as new-onset urinary retention, weakness, and decreased sensation in
her right leg.
Conclusion: Pain physicians should be mindful of the risks and benefits before deciding to hold or discontinue anticoagulation
in patients undergoing fluoroscopically guided sacroiliac joint injection, as intramuscular hematomas are
a possible complication.
Key words: Anticoagulation, hematoma, sacroiliac joint arthropathy, sacroiliac joint injection complications
Gluteus maximus metastasis from sacrococcygeal chordoma: A case report
