title: Ultrasound-guided versus fluoroscopy-guided sacroiliac joint intra-articular injections in the noninflammatory sacroiliac joint dysfunction: a prospective, randomized, single-blinded study.
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.
  
  
  METHODS
  Prospective, randomized controlled trial.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Patients (N=120) with noninflammatory sacroiliac arthritis were enrolled.
  
  
  METHODS
  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.
  
  
  METHODS
  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.affiliation: Department of Health & Fitness Management, Namseoul University, Cheonan-Si, Republic of Korea.
authors.forename: Haemi
authors.initials: H
authors.lastname: Jee
authors.affiliation: Department of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ji-Hae
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Rehabilitation Medicine, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Ki Deok
authors.initials: KD
authors.lastname: Park
authors.affiliation: Department of Physical Medicine & Rehabilitation, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jaeki
authors.initials: J
authors.lastname: Ahn
authors.affiliation: Department of Physical Medicine & Rehabilitation, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea. Electronic address: swc328@daum.net.
authors.forename: Yongbum
authors.initials: Y
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D001168:Arthritis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D003287:Contrast Media / Q000008:administration & dosage; D004185:Disability Evaluation; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D015641:Radiography, Interventional; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D013256:Steroids / Q000008:administration & dosage / Q000627:therapeutic use*; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D013256:Steroids
keywords: CT; FL; Fluoroscopy; IA; Injections; ODI; Oswestry Disability Index; Rehabilitation; SIJ; Sacroiliac joint; US; Ultrasonography; VNS; computed tomography; fluoroscopy; intra-articular; sacroiliac joint; ultrasound; verbal numeric pain scale