Efficacy of sacroiliac corticosteroid injections in patients with inflammatory spondyloarthropathy: results of a 6 month controlled study.
OBJECTIVE
To evaluate changes in articular symptoms, spinal mobility, and global function over 6 months after intraarticular injections of long acting corticosteroid into the sacroiliac (SI) joints of patients with inflammatory low back pain (ILBP).


METHODS
Nineteen patients with symptoms of ILBP were studied. Thirteen (68%) had radiographic evidence of sacroiliitis. The remaining 6 patients (32%) had normal imaging studies and thus were considered to have mechanical low back pain. All patients received bilateral SI joint injections of triamcinolone hexacetonide (40 mg/joint) under computer tomographic guidance. Outcome variables included the duration of low back morning stiffness, back pain (by visual analog scale, McGill Pain Questionnaire), spinal mobility (chest expansion, Schober test, 10 cm segments test, finger-fibula distance), and self-report health status (SF-36).


RESULTS
Both groups of patients showed a transient improvement in stiffness and pain, spinal mobility, and general health status that was most pronounced at 1-3 months after intraarticular therapy. This did not reach statistical significance (p > 0.05) and by 6 months, followup all outcome variables had reverted to pretherapy levels in both groups.


CONCLUSIONS
These preliminary observations suggest that SI corticosteroid injections are ineffective in the management of patients with inflammatory spondyloarthropathy.
Hanly
J G
JG
Department of Medicine, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada. jhanly@is.dal.ca
Mitchell
M
M
MacMillan
L
L
Mosher
D
D
Sutton
E
E
D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001416:Back Pain / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D006304:Health Status; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D008297:Male; D016059:Range of Motion, Articular / Q000187:drug effects; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging / Q000187:drug effects*; D013166:Spondylitis / Q000188:drug therapy* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide; C005900:triamcinolone hexacetonide