Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Ultrasound-Guided Sacroiliac Joint Injection in Patients with Sacroiliitis: Precise i.a. Injection Does Not Predict Outcome
Hartung1, Wolfgang, Scholmerich2, Jürgen, Straub2, Rainer H., Herold3, Thomas, Ross3, Christian J., Feuerbach3, Stefan, Fleck2, Martin
Intraarticular injections of sacroiliac joints (SIJ) with corticosteroids are often performed in patients suffering from low back pain due to active sacroiliitis. However, SIJ injections are technically demanding, and therefore the clinical outcome of ultrasound-guided corticosteroid SIJ injections was analyzed in relation to the accuracy of the injection.
Ultrasound-guided injections were performed with 40 mg triamcinolone and 0,78 mg gadolinium in 20 SIJ of 14 consecutive patients suffering from active sacroiliitis. Immediately following SIJ injection, MRI scanning was initiated to verify the correct placement of the drug. Clinical outcome of the intervention was determined using a numerical pain rating scale (NRS) at day 1 and 28.
Despite ultrasound guidance, only 8 injections (40%) were exactly positioned into the SIJ-space, whereas the other 12 injections (60%) missed the SIJ. However, there were no significant differences observed in the clinical outcome between the intraarticular-injected group and the periarticular-injected group. There was a similar pain relief observed in both groups 24h and 28 days following the intervention (intraarticular injection group: mean NRS-baseline: 6,8 [range 49], NRS-24h: 4,3 [range 17], NRS-day 28: 3,5 [range 15]; periarticular injection group: mean NRS-baseline: 7,0 [range 510], NRS-24h: 4,1 [range 110], NRS-day 28: 4,5 [range 18]).
These results demonstrate that intraarticular SIJ-injections remain technically challenging despite ultrasound guidance. However, periarticular deposition of triamcinolone appears sufficient for pain and symptom control in patients suffering from inflammatory low back pain due to active sacroiliitis.
To cite this abstract, please use the following information:
Hartung, Wolfgang, Scholmerich, Jürgen, Straub, Rainer H., Herold, Thomas, Ross, Christian J., Feuerbach, Stefan, et al; Ultrasound-Guided Sacroiliac Joint Injection in Patients with Sacroiliitis: Precise i.a. Injection Does Not Predict Outcome [abstract]. Arthritis Rheum 2009;60 Suppl 10 :522