Ebook Atlas of ultrasound-guided musculoskeletal injections: Part 2
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Ebook Atlas of ultrasound-guided musculoskeletal injections: Part 2
SECTION VPelvisCHAPTER 45Sacroiliac Joint InjectionMark-Friedrich Berthold Hurdle. MDKEY POINTS■Use a 25-23-gauge. 3.5-inch needle.■ The sacroiliac jo Ebook Atlas of ultrasound-guided musculoskeletal injections: Part 2oint is usually most accessible at the■A high-frequency curvilinear array transducer is required caudal pole.for most patients.■ The probe is placed in an axial plane over the joint.Pertinent AnatomyThe sacroiliac joint is a diarthrodial joint consisting of the articulation of the lateral sacrum wit Ebook Atlas of ultrasound-guided musculoskeletal injections: Part 2h posterior medial ilium (Figure 45-1 A. B). The joint is stabilized by posteriorsacroiliac ligament, sacrospinous ligament, sacrotuberous ligament (FEbook Atlas of ultrasound-guided musculoskeletal injections: Part 2
igure 45-IC). The cephalad portion of the posterior joint contains the interosseous ligament and is not a true joint capsule.Sacro-iliac jointFIGURE 4SECTION VPelvisCHAPTER 45Sacroiliac Joint InjectionMark-Friedrich Berthold Hurdle. MDKEY POINTS■Use a 25-23-gauge. 3.5-inch needle.■ The sacroiliac jo Ebook Atlas of ultrasound-guided musculoskeletal injections: Part 2tions including degenerative changes, joint infections, structural abnormalities. inflammatory disorders, pregnancy, joint dysfunction, and metabolic conditions have been implicated in sacroiliac joint pain. Sacroiliac joint (SIJ) pain referral patterns may overlap other painful conditions involving Ebook Atlas of ultrasound-guided musculoskeletal injections: Part 2 the low back and lower extremities. Typically, sacroiliac pain involves the posterior superior iliac crest region of the affected side radiating distEbook Atlas of ultrasound-guided musculoskeletal injections: Part 2
ally. Although a host of provocative maneuvers arc helpful in establishing the diagnosis, an intraarticular injection can help with confirmation.UltraSECTION VPelvisCHAPTER 45Sacroiliac Joint InjectionMark-Friedrich Berthold Hurdle. MDKEY POINTS■Use a 25-23-gauge. 3.5-inch needle.■ The sacroiliac jo Ebook Atlas of ultrasound-guided musculoskeletal injections: Part 2 side of interest (Figure 45 2). The SI foramen can be visual ized medial to the cleft of the upper portion of the SIJ. The probe is then kept in the axial plane and slid distally until the lower pole is seen close to the posterior sacral foramen of S2.FIGURE 15-2 ■ Ultrasound image of superior sacr Ebook Atlas of ultrasound-guided musculoskeletal injections: Part 2oiliac joint. Arrow points to joint opening.Indications for Injections of the Sacroiliac JointInjection of the SIJ can he performed on patients with SEbook Atlas of ultrasound-guided musculoskeletal injections: Part 2
IJ pain that does not respond to conservative interventions including physical therapy, relative rest, antiinflammatories, and modalities. Injection oSECTION VPelvisCHAPTER 45Sacroiliac Joint InjectionMark-Friedrich Berthold Hurdle. MDKEY POINTS■Use a 25-23-gauge. 3.5-inch needle.■ The sacroiliac jo Ebook Atlas of ultrasound-guided musculoskeletal injections: Part 2roscopy as the control.1 Ultrasound-guided SIJ injections have been described by Klauser et al. and Pekkafahli el al. with an accuracy rate between 76% and 93%.-; ('finical outcomes of ultrasound-guided versus fluoroscopically guided sacroiliac joints have not been described.186 1 Chapter 451 Sacroi Ebook Atlas of ultrasound-guided musculoskeletal injections: Part 2liac Joint InjectionEquipmentNeedle: 25-23-gaugc. 3.5-inch needleInjectate•I ml. local anesthetic•1 mL of an injectable corticosteroidHigh-frequency cEbook Atlas of ultrasound-guided musculoskeletal injections: Part 2
urvilinear array transducerAuthor's Preferred Techniquea.Patient positioni.Prone with pillow placed under pelvis for mild hip flexionb.Transducer posiSECTION VPelvisCHAPTER 45Sacroiliac Joint InjectionMark-Friedrich Berthold Hurdle. MDKEY POINTS■Use a 25-23-gauge. 3.5-inch needle.■ The sacroiliac joSECTION VPelvisCHAPTER 45Sacroiliac Joint InjectionMark-Friedrich Berthold Hurdle. MDKEY POINTS■Use a 25-23-gauge. 3.5-inch needle.■ The sacroiliac joGọi ngay
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