Evaluation and Management of Sacroiliac Joint Dysfunction

This presentation will discuss the basic concepts of the evaluation of patients with various degrees of sacroiliac joint dysfunction, including presenting symptoms and pain referral patterns. Basic exam findings and special tests and their respective predictive values will be demonstrated. The sensitivity and specificity of guided sacroiliac joint injections will also be discussed as part of zooming into the diagnosis of this musculoskeletal entity. Various therapeutic approaches will be illustrated, including specific physical therapy protocols, physical modalities, manipulation techniques, and interventional therapeutic procedures. The importance of guided injections will be reviewed, along with the literature for various approaches such as ultrasound, fluoroscopy, and contemporary radio frequency/denervation procedures, emphasizing neuroanatomical principles. Special attention will be paid to the importance of knowing the limitations and pitfalls of imaging tests in the evaluation of this condition. The existing relevant literature regarding the correlation between imaging and sacroiliac pain will be discussed in detail, using clinical scenarios and illustrative cases. (Recorded at PAINWeek 2019)