100 Years of Sacroiliac Joint Uncertainty: Is It a Common Source of Pain? Is That Pain Diagnosable and Treatable?

2022 ◽  
Vol 37 (1) ◽  
pp. 1-9
Keyword(s):  
Sacroiliac Joint ◽  
Common Source

scholarly journals Use of Ultrasound-Guided Platelet-Rich Plasma Injection of the Sacroiliac Joint as a Treatment for Chronic Low Back Pain

2019 ◽  
Vol 185 (7-8) ◽  
pp. e1312-e1317
Author(s):  
Devin Y Broadhead ◽  
Hannah E Douglas ◽  
Laurie M Bezjian Wallace ◽  
Patrick J Wallace ◽  
Sarah Tamura ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Sacroiliac Joint ◽  
Functional Disability ◽  
Platelet Rich Plasma ◽  
Common Source ◽  
Low Back ◽  
Ultrasound Guided ◽  
Long Term Treatment

ABSTRACT Back pain and its associated complications are of increasing importance among military members. The sacroiliac joint (SIJ) is a common source of chronic low back pain (LBP) and functional disability. Many patients suffering from chronic LBP utilize opioids to help control their symptoms. Platelet-rich plasma (PRP) has been used extensively to treat pain emanating from many different musculoskeletal origins; however, its use in the SIJ has been studied only on a limited basis. The patient in this case report presented with chronic LBP localized to the SIJ and subsequent functional disability managed with high-dose opioids. After failure of traditional treatments, she was given an ultrasound-guided PRP injection of the SIJ which drastically decreased her pain and disability and eventually allowed for complete opioid cessation. Her symptom relief continued 1 year after the injection. This case demonstrates the potential of ultrasound-guided PRP injections as a long-term treatment for chronic LBP caused by SIJ dysfunction in military service members, which can also aid in the weaning of chronic opioid use.

scholarly journals Sacroiliac Joint Ligaments and Sacroiliac Pain: A Case–Control Study on Micro- and Ultrastructural Findings on Morphologic Alterations

2019 ◽  
Vol 6 (22;6) ◽  
pp. E615-E625 ◽  
Author(s):  
Niels Hammer
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sacroiliac Joint ◽  
Case Control Study ◽  
Case Control ◽  
Small Sample ◽  
Common Source ◽  
Low Back ◽  
History Of ◽  
Control Study

Background: The sacroiliac joint (SIJ) is a common source of low back pain. SIJ pain has shown to have negative impact on patients’ quality of life. Although clinically there is an increasing interest to treat SIJ-related pain both conservatively and surgically, the underlying mechanisms related to pathology in that region are poorly understood. One hypothesis is that the SIJ ligaments are structurally altered in SIJ pain. Objectives: The given study investigated patient cases with different pain durations undergoing posterior distraction arthrodesis of the SIJ, with subsequent micro- and ultrastructural assessment of the interosseous and posterior SIJ ligaments compared with autopsy controls without known history of low back pain. Study Design: Case–control study. Morphologic-pathological analysis of tissue samples obtained during surgery with controls from legal medicine. Setting: Rural hospital setting in Halberstadt, Germany. Methods: SIJ ligaments were removed from 6 patients undergoing SIJ arthrodesis for histological and ultrastructural assessment in scanning and transmission electron microscopy, and compared with 6 controls without known history of SIJ pathology. Results: A number of alterations were observed in the ligaments of patients with SIJ, namely ligament disruption, collagen loosening and coiling, vascularization, and hemorrhage. In some areas, these changes were observed in proximity to healthy (structurally unaltered and intact tissues), indicative of a potential disease progression. Comparison to controls yielded a significant correlation between SIJ pathology and the level of collagen degeneration (φ ≥ 0.82; P < 0.001). Limitations: Small sample size, method of tissue removal from patients may have influenced tissue integrity. Conclusions: The combined clinical, histological, and ultrastructural analysis provided, to our knowledge, first-time evidence of morphologic SIJ ligament alteration of a nontraumatic and noninflammatory cause. Further research is necessary to elucidate these structural changes and to substantiate pain duration and patient-history-dependent changes at the ligaments of the posterior pelvis

scholarly journals Double Needle Technique: An Alternative Method for Performing Difficult Sacroiliac Joint Injections

2011 ◽  
Vol 3;14 (3;5) ◽  
pp. 281-284
Author(s):  
Sanjeeva Gupta
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sacroiliac Joint ◽  
Joint Line ◽  
Complex Nature ◽  
Common Source ◽  
Low Back ◽  
Needle Technique ◽  
Large Joint ◽  
The Right

The sacroiliac joint (SIJ) is a common source of low back pain. The most appropriate method of confirming SIJ pain is to inject local anesthesia into the joint to find out if the pain decreases. Unfortunately, although the SIJ is a large joint, it can be difficult to enter due to the complex nature of the joint and variations in anatomy. In my experience a double needle technique for sacroiliac joint injection can increase the chances of accurate injection into the SIJ in difficult cases. After obtaining appropriate fluoroscopic images, the tip of the needle is advanced into the SIJ. Once the tip of the needle is correctly placed, its position is checked under continuous fluoroscopy while moving the C-arm in the right and left oblique directions (dynamic fluoroscopy). On dynamic fluoroscopy the tip of the needle should remain within the joint line and not appear to be on the bone. If the tip of the needle appears to be on the bone a new joint line will need to be identified (the most translucent area through the joint) by dynamic fluoroscopy and another needle advanced into the newly identified joint line. Dynamic fluoroscopy is repeated again to confirm that the tip of the second needle remains within the joint line. Once both needles are in place contrast dye is injected through the needle that is most likely to be in the SIJ. If the contrast dye spread is not satisfactory then it is injected through the other needle. I have used this technique in 10 patients and found it very helpful in accurately performing SIJ injection which can at times be challenging. Key words: double needle techique, sacroiliac joint, low back pain, contrast dye, fluoroscopy

Sacroiliac joint conditions

2021 ◽  
pp. 15-26
Author(s):  
Anshuman R. Swain ◽  
Chong H. Kim ◽  
Mark N. Malinowski
Keyword(s):  
Low Back Pain ◽  
Sacroiliac Joint ◽  
Secondary Trauma ◽  
Calcium Pyrophosphate ◽  
Common Source ◽  
Calcium Pyrophosphate Dihydrate ◽  
Inflammatory Conditions ◽  
Pyrophosphate Dihydrate ◽  
The Impact ◽  
Multiple Conditions

The sacroiliac joint is a common source of chronic low back pain. Multiple conditions can result in the development of pain within this axial joint. These conditions may be both pathologic or nonpathologic. Pain may result from injury from an intraarticular as well as an extraarticular source. Pain in the sacroiliac joint may result from degenerative, traumatic, and inflammatory conditions. Conditions covered in this chapter are osteoarthritis, sacroiliac joint dysfunction, infection (pyogenic or granulomatous), crystalline-induced sacroiliitis (found in gout and calcium pyrophosphate dihydrate deposition disease), spondyloarthropathies, reactive arthritis, malignancy (primary and secondary), trauma. The impact of pregnancy on the sacroiliac joint is also discussed.

scholarly journals Minimally Invasive Sacroiliac Joint Fusion: 2-Year Radiographic and Clinical Outcomes with a Principles-Based SIJ Fusion System

2018 ◽  
Vol 12 (1) ◽  
pp. 7-16 ◽  
Author(s):  
William W Cross ◽  
Arnold Delbridge ◽  
Donald Hales ◽  
Louis C Fielding
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Minimally Invasive ◽  
Sacroiliac Joint ◽  
Pain Scale ◽  
Common Source ◽  
Fusion System ◽  
Low Back ◽  
Solid Fusion ◽  
Sacroiliac Joint Fusion

Background:Sacroiliac joint (SIJ) degeneration is a common source of low back pain (LBP). Minimally invasive (MI) SIJ fusion procedures have demonstrated meaningful clinical improvement. A recently developed MI SIJ fusion system incorporates decortication, placement of bone graft and fixation with threaded implants (DC/BG/TF).Patients and Methods:Nineteen patients who had MI SIJ fusion with DC/BG/TF were enrolled at three centers. Fusion was assessed in CT images obtained 12 and 24 months postoperatively by an independent radiographic core laboratory. LBP was assessed using a 0-10 numerical pain scale (NPS) preoperatively and at 12 and 24 months postoperatively.Results:At 12 months, 15/19 patients (79%) had bridging bone across the SIJ, and at 24 months 17/18 patients (94%) available for follow-up had SIJ fusion. Of the patients with bridging bone 88% had fusion within the decorticated area, with solid fusion in 83%. A significant reduction in NPS scores was demonstrated, representing a 73% reduction in average low back pain.Conclusion:The patients in this series demonstrated significant improvement in LBP. Fusion rates at 24 months demonstrate promise for this system, which utilizes the established orthopedic principles of DC/BG/TF to achieve arthrodesis. Further study is warranted to demonstrate comparative fusion rates for different implant systems.

Identifying groups of airborne particles by ordination

1994 ◽  
Vol 52 ◽  
pp. 856-857
Author(s):  
M. Shlepr ◽  
C. M. Vicroy
Keyword(s):  
Elemental Analysis ◽  
Energy Dispersive Spectroscopy ◽  
Manufacturing Process ◽  
Spatial Representation ◽  
Airborne Particles ◽  
Common Source ◽  
Data Set ◽  
Microelectronics Industry ◽  
Induced Changes ◽  
Source Materials

The microelectronics industry is heavily tasked with minimizing contaminates at all steps of the manufacturing process. Particles are generated by physical and/or chemical fragmentation from a mothersource. The tools and macrovolumes of chemicals used for processing, the environment surrounding the process, and the circuits themselves are all potential particle sources. A first step in eliminating these contaminants is to identify their source. Elemental analysis of the particles often proves useful toward this goal, and energy dispersive spectroscopy (EDS) is a commonly used technique. However, the large variety of source materials and process induced changes in the particles often make it difficult to discern if the particles are from a common source.Ordination is commonly used in ecology to understand community relationships. This technique usespair-wise measures of similarity. Separation of the data set is based on discrimination functions. Theend product is a spatial representation of the data with the distance between points equaling the degree of dissimilarity.

Elevated Tissue Factor and Tissue Factor Pathway Inhibitor Circulating Levels in Ischaemic Heart Disease Patients

1998 ◽  
Vol 79 (03) ◽  
pp. 495-499 ◽  
Author(s):  
Anna Maria Gori ◽  
Sandra Fedi ◽  
Ludia Chiarugi ◽  
Ignazio Simonetti ◽  
Roberto Piero Dabizzi ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Tissue Factor ◽  
Plasma Levels ◽  
Tissue Factor Pathway Inhibitor ◽  
Common Source ◽  
Previous Myocardial Infarction ◽  
Control Subjects ◽  
Tissue Factor Pathway ◽  
Circulating Levels

SummarySeveral studies have shown that thrombosis and inflammation play an important role in the pathogenesis of Ischaemic Heart Disease (IHD). In particular, Tissue Factor (TF) is responsible for the thrombogenicity of the atherosclerotic plaque and plays a key role in triggering thrombin generation. The aim of this study was to evaluate the TF/Tissue Factor Pathway Inhibitor (TFPI) system in patients with IHD.We have studied 55 patients with IHD and not on heparin [18 with unstable angina (UA), 24 with effort angina (EA) and 13 with previous myocardial infarction (MI)] and 48 sex- and age-matched healthy volunteers, by measuring plasma levels of TF, TFPI, Prothrombin Fragment 1-2 (F1+2), and Thrombin Antithrombin Complexes (TAT).TF plasma levels in IHD patients (median 215.4 pg/ml; range 72.6 to 834.3 pg/ml) were significantly (p<0.001) higher than those found in control subjects (median 142.5 pg/ml; range 28.0-255.3 pg/ml).Similarly, TFPI plasma levels in IHD patients were significantly higher (median 129.0 ng/ml; range 30.3-316.8 ng/ml; p <0.001) than those found in control subjects (median 60.4 ng/ml; range 20.8-151.3 ng/ml). UA patients showed higher amounts of TF and TFPI plasma levels (TF median 255.6 pg/ml; range 148.8-834.3 pg/ml; TFPI median 137.7 ng/ml; range 38.3-316.8 ng/ml) than patients with EA (TF median 182.0 pg/ml; range 72.6-380.0 pg/ml; TFPI median 115.2 ng/ml; range 47.0-196.8 ng/ml) and MI (TF median 213.9 pg/ml; range 125.0 to 341.9 pg/ml; TFPI median 130.5 ng/ml; range 94.0-207.8 ng/ml). Similar levels of TF and TFPI were found in patients with mono- or bivasal coronary lesions. A positive correlation was observed between TF and TFPI plasma levels (r = 0.57, p <0.001). Excess thrombin formation in patients with IHD was documented by TAT (median 5.2 μg/l; range 1.7-21.0 μg/l) and F1+2 levels (median 1.4 nmol/l; range 0.6 to 6.2 nmol/l) both significantly higher (p <0.001) than those found in control subjects (TAT median 2.3 μg/l; range 1.4-4.2 μg/l; F1+2 median 0.7 nmol/l; range 0.3-1.3 nmol/l).As in other conditions associated with cell-mediated clotting activation (cancer and DIC), also in IHD high levels of circulating TF are present. Endothelial cells and monocytes are the possible common source of TF and TFPI. The blood clotting activation observed in these patients may be related to elevated TF circulating levels not sufficiently inhibited by the elevated TFPI plasma levels present.

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