Sacroiliac Joint Pain




(1)
Department of Anaesthesia, Royal Free Hospital, London, UK

 



The sacroiliac joint is a diarthrodial joint (synovial). It is the largest axial joint in the body and is formed by the sacrum and ileum. Its average surface area is 17.5 cm2. The anterior joint is supplied by L2–S2 ventral rami and posterior joint by L3–S3 dorsal rami. It accounts for 15–20 % of chronic low back pain. Risk factors include activities involving unilateral loading (skiing, rowing), pregnant women, increased lordosis, weight gain and leg length discrepancy.


47.1 Clinical Features


Most of the patients present with medial buttock discomfort and pain in sacral sulcus. Pain may be referred to hip, groin and abdomen. The two characteristic features are presence of groin pain and absence of pain above L5. There may be weakness of the gluteus medius muscle with tightening of the piriformis and quadratus lumborum. Nerve root signs are not positive and movements of the spine are not affected. Mostly, the pain is unilateral.


47.2 Diagnosis


There is no single diagnostic test. Diagnosis is confirmed by eliciting pain in the sacroiliac joint.

Mar 20, 2017 | Posted by in PAIN MEDICINE | Comments Off on Sacroiliac Joint Pain
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