Sacroiliac Joint Pain (cont.)
What are the symptoms of sacroiliac joint dysfunction?
The most common symptom of SI joint dysfunction is pain. Patients often
experience pain in the lower back or the back of the hips. Pain may also be
present in the groin and thighs. In many cases it can be difficult to determine
the exact source of the pain. Your physician can perform specific tests to help
isolate the source of the pain. The pain is typically worse with standing and
walking and improved when lying down. Inflammation and arthritis in the SI joint
can also cause stiffness and a burning sensation in the pelvis.
How is sacroiliac joint dysfunction diagnosed?
The first step in diagnosis is typically a thorough history and physical
examination by a physician. The physician will ask questions to determine if
there are any underlying disorders that could be causing the patient's pain. This can
also help differentiate pain coming from the SI joints, lumbar spine, or hips.
There are various tests a physician can perform during the physical
examination that can help isolated the source of the pain. Other portions of
the examination are to exclude certain possibilities that could mimic sacroiliac
disease.
The next step in diagnosis is often plain radiographs (x-rays). The patient may have
x-rays of the pelvis, hips or lumbar spine depending on what the physician
finds on the history and physical examination. A
computed tomography (CAT or
CT) scan may also help in the diagnosis. CT scan gives a more detailed look at the
joint and bones. A magnetic resonance imaging (MRI) scan can also be helpful.
This provides a better evaluation of the soft tissues including muscles and
ligaments. It can also identify subtle fractures that may not be seen on an
x-ray. A bone scan can be obtained to help isolate the source of your pain and
can be used to identify bony abnormalities. The bone scan can identify areas of
increased activity in the bone. This is a nonspecific test and can be positive
in cases of arthritis, infection, and fracture or tumors of bone.
Often the most accurate method of diagnosing SI joint dysfunction is by
performing an injection that can numb the irritated area, thereby identifying
the pain source. An anesthetic material (for example,
lidocaine, novacaine) can be
injected along with a steroid (cortisone) directly into the SI joint. This is
usually performed with the aid of an x-ray machine to verify the injection is in
the SI joint. The anesthetic and steroid can help relieve the pain from
inflammation that is common with SI joint dysfunction. The duration of pain
relief is variable, but this is very useful to determine that the SI joint is
the source of the pain.
Next: How is sacroiliac joint dysfunction treated? »
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