X-ray SI Joint Injection

Introduction

The pelvis is made up of two hip bones located and fused on either side of the sacrum, the last section of the backbone. Each hip bone is comprised of three bones fused together – the ilium, ischium and pubis. The sacroiliac joints are the two joints present in your lower back where the sacrum and ilium join. These joints may become painful and inflamed due to various conditions.

A sacroiliac joint injection is a mixture of an anesthetic which blocks pain impulses and a steroid which reduces inflammation and is a conservative treatment to relieve these symptoms.

Disease Overview

The sacroiliac joints help bear your body’s weight while standing and may become painful and inflamed due to stress and certain medical conditions leading to pain in the lower back, buttocks, hips, groin and legs. The pain may increase with certain activities and movements.

Indications

Sacroiliac joint injections are usually indicated to treat sacroiliac joint dysfunction not relieved by other conservative treatment options.  

Sacroiliac joint dysfunction has many causes including:

  • inflammation,
  • arthritis,
  • spondylitis,
  • degenerative bone disease,
  • gait abnormalities,
  • pregnancy

It can also occur when an abnormal gait is present in cases of polio, injury to one of the legs or feet, limb length discrepancy or walking with crutches or a cane.

Procedure

Sacroiliac joint injection is an X-ray guided procedure performed under sedation while lying face down on an X-ray table.

  • The injection site is identified on your back with the help of X-ray guidance.
  • The skin over this site is cleansed and covered with sterile drapes.
  • An anesthetic injection is administered to numb the skin.
  • A needle is guided into the sacroiliac joint with the help of live X-ray imaging and a dye is instilled to confirm its position.
  • An injection of anesthetic and steroid is then administered.
  • You may experience a sensation similar to warm water flowing down your legs.
  • Once completed, the needle is removed, and you are taken to the recovery room.
  • The procedure takes approximately 10-15 minutes.
  • You are observed for about 15 minutes after the procedure and once stable may return home.

Post-Operative Care

Your doctor will prescribe medication and ice pack applications to help relieve any pain and soreness at the injection site.

You are advised not to drive, bathe or shower immediately after the procedure. The anesthetic in the injection usually has an immediate effect. The steroid component will start to show effects in 2-3 days.

Advantages & Disadvantages

X-ray guided sacroiliac joint injections are advantageous as they provide significant pain relief when medications and other conservative treatments are inadequate and surgery is not recommended. The procedure is minimally invasive and may be repeated 3 times a year.

Risks and complications

Risks and complications with this procedure are rare and include bleeding, bruising, infection, allergic reaction and headache.

  • North American Spine Society
  • American Academy of Orthopaedic Surgeons
  • American Osteopathic Academy of Orthopedics
  • American Osteopathic Association
  • Dignity health St johns medical center
  • Community Memorial Health System
  • New England Baptist Hospital
  • Manonmaniam Sundaranar University