Article

OBJECTIVE: To compare the short-term effects and safety of ultrasound (US)-guided
sacroiliac joint (SIJ) injections with fluoroscopy (FL)-guided SIJ injections in
patients with noninflammatory SIJ dysfunction. DESIGN: Prospective, randomized
controlled trial. SETTING: University hospital. PARTICIPANTS: Patients (N=120)
with noninflammatory sacroiliac arthritis were enrolled. INTERVENTION: All
procedures were performed using an FL or US apparatus. Subjects were randomly
assigned to either the FL or US group. Immediately after the SIJ injections,
fluoroscopy was applied to verify the correct placement of the injected
medication and intravascular injections. MAIN OUTCOME MEASURES: Treatment effects
and functional improvement were compared at 2 and 12 weeks after the procedures.
RESULTS: The verbal numeric pain scale and Oswestry Disability Index improved at
2 and 12 weeks after the injections without statistical significances between
groups. Of 55 US-guided injections, 48 (87.3%) were successful and 7 (12.7%) were
missed. The FL-guided SIJ approach exhibited a greater accuracy (98.2%) than the
US-guided approach. Vascularization around the SIJ was seen in 34 of 55 patients.
Among the 34 patients, 7 had vascularization inside the joint, 23 had
vascularization around the joint, and 4 had vascularization both inside and
around the joint. Three cases of intravascular injections occurred in the FL
group. CONCLUSIONS: The US-guided approach may facilitate the identification and
avoidance of the critical vessels around or within the SIJ. Function and pain
relief significantly improved in both groups without significant differences
between groups. The US-guided approach was shown to be as effective as the
FL-guided approach in treatment effects. However, diagnostic application in the
SIJ may be limited because of the significantly lower accuracy rate (87.3%).
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS