title: Sciatica-like symptoms and the sacroiliac joint: clinical features and differential diagnosis.
abstract: OBJECTIVE
  To compare the clinical features of patients with sacroiliac joint (SIJ)-related sciatica-like symptoms to those with sciatica from nerve root compression and to investigate the necessity to perform radiological imaging in patients with sciatica-like symptoms derived from the SIJ.
  
  
  METHODS
  Patients with pain radiating below the buttocks with a duration of 4 weeks to 1 year were included. After physical and radiological examinations, a diagnosis of SI joint-related pain, pain due to disk herniation, or a combination of these two causes was made.
  
  
  RESULTS
  Patients with SIJ-related leg pain (n = 77/186) were significantly more often female, had shorter statue, a shorter duration of symptoms, and had more often pain radiating to the groin and a history of a fall on the buttocks. Muscle weakness, corkscrew phenomenon, finger-floor distance ≥25 cm, lumbar scoliosis, positive Bragard or Kemp sign, and positive leg raising test were more often present when radiologic nerve root compression was present. Although these investigations may help, MRI of the spine is necessary to discriminate between the groups.
  
  
  CONCLUSIONS
  Sciatica-like symptoms derived from the SIJ can clinically mimic a radiculopathy. We suggest to perform a thorough physical examination of the spine, SI joints, and hips with additional radiological tests to exclude other causes.
authors: Department of Neurology, St. Elisabeth Hospital, PO Box 90151, 5000 LC Tilburg, The Netherlands. l.visser@elisabeth.nl
authors: L H
authors: LH
authors: Visser
authors: P G N
authors: PG
authors: Nijssen
authors: C C
authors: CC
authors: Tijssen
authors: J J
authors: JJ
authors: van Middendorp
authors: J
authors: J
authors: Schieving
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D011843:Radiculopathy / Q000150:complications / Q000175:diagnosis*; D012446:Sacroiliac Joint / Q000473:pathology*; D012585:Sciatica / Q000209:etiology*