Sacroiliac Pain: Structural Causes of Pain Referring to the SI Joint Region
| Autor: | Lisa A. Zalepa King, Nicholas N. DePhillipo, Eric Strauch, Donald S. Corenman |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
musculoskeletal diseases
Male medicine.medical_specialty Physical examination 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Anterior compartment of thigh Sacroiliac joint 030222 orthopedics Referred pain Groin medicine.diagnostic_test business.industry Retrospective cohort study Sacroiliac Joint Middle Aged Low back pain Arthralgia medicine.anatomical_structure Physical therapy Surgery Female Neurology (clinical) medicine.symptom Differential diagnosis business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Clinical spine surgery. 32(6) |
| ISSN: | 2380-0194 |
| Popis: | BACKGROUND The currently reported incidence of primary sacroiliac joint (SIj) pathology ranges from 15% to 30%. The differential diagnosis of SIj region pain includes pain generated from the lumbar spine, the SIj, and the hip joint. The origins of SIj dysfunctions are controversial and pain generation from this joint has been questioned. PURPOSE Retrospectively analyze the relative incidence of lumbar spine, SIj, and hip joint etiologies in patients complaining of ≥50% SIj region pain. STUDY DESIGN This is a retrospective cohort case series. METHODS Inclusion criteria: chief complaint SIj pain (≥50% of overall complaint). In total, 124 patients charts were reviewed from a single spine surgeon's clinic. All patients were evaluated by the same 2 practitioners and all cases were reviewed for clinical examination findings, diagnostic tests performed, final diagnosis, treatment, and clinical follow-up. RESULTS After complete diagnostic workup, 112 (90%) had lumbar spine pain, 5 (4%) had hip pain, 4 (3%) had primary SIj pain, and 3 (3%) had an undetermined source of pain upon initial diagnosis. SIj pain generation was confirmed via fluoroscopy-guided diagnostic injections. Following designated treatment, 11 (9%) patients returned to clinic at an average of 2.4 years complaining of continued/recurrent SIj region pain. Further investigation revealed 6 patients had confirmed pain generation from the lumbar spine, 3 patients had confirmed pain generation from the SIj, and 2 patients had undetermined sources of pain. CONCLUSIONS The SIj is a rare pain generator (3%-6%) in patients complaining of ≥50% SIj region pain and is a common site of referral pain from the lumbar spine (88%-90%). Clinicians ought to quantify areas of pain (via percent of overall complaint) when interviewing their patients complaining of low back pain to distinguish potential pain generators. Recommended breakdown of areas of interest include axial low back, SIj region, buttock/leg, groin/anterior thigh. |
| Databáze: | OpenAIRE |
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