Haemi Jee1, Ji-Hae Lee2, Ki Deok Park3, Jaeki Ahn4, Yongbum Park5. 1. Department of Health & Fitness Management, Namseoul University, Cheonan-Si, Republic of Korea. 2. Department of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea. 3. Department of Rehabilitation Medicine, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Republic of Korea. 4. Department of Physical Medicine & Rehabilitation, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea. 5. Department of Physical Medicine & Rehabilitation, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea. Electronic address: swc328@daum.net.
Abstract
OBJECTIVE: To compare the short-term effects and safety of ultrasound (US)-guided sacroiliac joint (SIJ) injections with fluoroscopy (FL)-guided SIJ injections in patients with noninflammatory SIJ dysfunction. DESIGN: Prospective, randomized controlled trial. SETTING:University hospital. PARTICIPANTS: Patients (N=120) with noninflammatory sacroiliac arthritis were enrolled. INTERVENTION: All procedures were performed using an FL or US apparatus. Subjects were randomly assigned to either the FL or US group. Immediately after the SIJ injections, fluoroscopy was applied to verify the correct placement of the injected medication and intravascular injections. MAIN OUTCOME MEASURES: Treatment effects and functional improvement were compared at 2 and 12 weeks after the procedures. RESULTS: The verbal numeric pain scale and Oswestry Disability Index improved at 2 and 12 weeks after the injections without statistical significances between groups. Of 55 US-guided injections, 48 (87.3%) were successful and 7 (12.7%) were missed. The FL-guided SIJ approach exhibited a greater accuracy (98.2%) than the US-guided approach. Vascularization around the SIJ was seen in 34 of 55 patients. Among the 34 patients, 7 had vascularization inside the joint, 23 had vascularization around the joint, and 4 had vascularization both inside and around the joint. Three cases of intravascular injections occurred in the FL group. CONCLUSIONS: The US-guided approach may facilitate the identification and avoidance of the critical vessels around or within the SIJ. Function and pain relief significantly improved in both groups without significant differences between groups. The US-guided approach was shown to be as effective as the FL-guided approach in treatment effects. However, diagnostic application in the SIJ may be limited because of the significantly lower accuracy rate (87.3%).
RCT Entities:
OBJECTIVE: To compare the short-term effects and safety of ultrasound (US)-guided sacroiliac joint (SIJ) injections with fluoroscopy (FL)-guided SIJ injections in patients with noninflammatory SIJ dysfunction. DESIGN: Prospective, randomized controlled trial. SETTING: University hospital. PARTICIPANTS: Patients (N=120) with noninflammatory sacroiliac arthritis were enrolled. INTERVENTION: All procedures were performed using an FL or US apparatus. Subjects were randomly assigned to either the FL or US group. Immediately after the SIJ injections, fluoroscopy was applied to verify the correct placement of the injected medication and intravascular injections. MAIN OUTCOME MEASURES: Treatment effects and functional improvement were compared at 2 and 12 weeks after the procedures. RESULTS: The verbal numeric pain scale and Oswestry Disability Index improved at 2 and 12 weeks after the injections without statistical significances between groups. Of 55 US-guided injections, 48 (87.3%) were successful and 7 (12.7%) were missed. The FL-guided SIJ approach exhibited a greater accuracy (98.2%) than the US-guided approach. Vascularization around the SIJ was seen in 34 of 55 patients. Among the 34 patients, 7 had vascularization inside the joint, 23 had vascularization around the joint, and 4 had vascularization both inside and around the joint. Three cases of intravascular injections occurred in the FL group. CONCLUSIONS: The US-guided approach may facilitate the identification and avoidance of the critical vessels around or within the SIJ. Function and pain relief significantly improved in both groups without significant differences between groups. The US-guided approach was shown to be as effective as the FL-guided approach in treatment effects. However, diagnostic application in the SIJ may be limited because of the significantly lower accuracy rate (87.3%).
Authors: Niels Hammer; Mario Scholze; Thomas Kibsgård; Stefan Klima; Stefan Schleifenbaum; Thomas Seidel; Michael Werner; Ronny Grunert Journal: J Anat Date: 2018-12-09 Impact factor: 2.610
Authors: Philipp Bosch; Francesco Carubbi; Carlo Alberto Scirè; Xenofon Baraliakos; Louise Falzon; Christian Dejaco; Pedro M Machado Journal: RMD Open Date: 2021-11
Authors: Stefan Klima; Ronny Grunert; Benjamin Ondruschka; Mario Scholze; Thomas Seidel; Michael Werner; Niels Hammer Journal: Sci Rep Date: 2018-10-29 Impact factor: 4.379