The Success Rate of Ultrasound‐Guided Sacroiliac Joint Steroid Injections in Sacroiliitis: Are We Getting Better?

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Abstract
Background Sacroiliac joint is one of the most common sources of low back pain, however it is difficult to place the needle accurately inside the joint space without image guidance, improvement of ultrasound technology may lead to high success rate of intra‐articular drug deposition. Objective Assessment of the success rate of ultrasound guided intra‐articular sacroiliac joint injection. Design prospective observational study. Methodology Ultrasound‐guided injections were performed for 34 patients suffering from sacroiliitis. After injection of the drug solution and withdrawal of the needle, an anteroposterior fluoroscopy image was obtained and recorded for the injected joint to detect whether it was pre‐dominantly intraarticular or periarticular, Clinical outcome using a numerical pain rating scale as well as limitation of physical functioning measured by the Oswestry Disability Index(ODI) were determined. Results 33 injections (84.6%) were intra‐articular, while 6 injections (15.4%) were periarticular as confirmed by fluoroscopy with no statistical difference regarding clinical outcome between them. The baseline mean pain score decreased from 7.21 to 1.92 one month after injection and the ODI results improved from a mean of 61.41 to 17.13. Intervention was well tolerated and 91.2% of patients were satisfied or most satisfied. Conclusion ultrasonography provides a high success rate of intraarticular sacroiliac joint injection as confirmed by fluoroscopy, no significant difference in clinical outcome between intraarticular and periarticular injection was found.

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