title: Fluoroscopically Guided Sacroiliac Joint Injections: Comparison of the Effects of Intraarticular and Periarticular Injections on Immediate and Short-Term Pain Relief.
abstract: OBJECTIVE
  The purpose of this study was to determine whether intraarticular sacroiliac joint injections provide greater immediate and short-term pain relief than periarticular sacroiliac joint injections do.
  
  
  METHODS
  The records of all fluoroscopically guided sacroiliac joint injections performed over a 4-year period were identified. Patients who received an injection of 0.5 mL of bupivacaine and 0.5 mL (20 mg) of triamcinolone and who had preinjection, immediate, and 1-week postinjection pain scores (0-10 numeric scale) were included. Images from the procedures were retrospectively reviewed by two musculoskeletal radiologists to determine intraarticular or periarticular administration of the injection with discrepancies resolved by consensus.
  
  
  RESULTS
  One hundred thirteen injections in 99 patients (65 women, 34 men; mean age, 59.4 years) met the inclusion criteria. There were 55 intraarticular and 58 periarticular injections. The mean preinjection, immediate, and 1-week postinjection pain scores for the intraarticular injections were 6.0, 1.6, and 4.1 and for the periarticular injections were 6.1, 2.0, and 4.2. The mean immediate and 1-week postinjection pain reduction were statistically significant in both groups (p < 0.001). After adjustment for age, sex, preinjection pain score, time of year, and indication for injection, no significant difference in the preinjection to immediately postinjection change in pain between intraarticular and periarticular injections (mean change, 0.37; p = 0.319) or in the preinjection to 1-week postinjection change in pain (mean change, 0.06; p = 0.888) was noted. The mean fluoroscopy times were 42.4 seconds for intraarticular injections and 60.5 seconds for periarticular injections (p = 0.32).
  
  
  CONCLUSIONS
  Although both intraarticular and periarticular sacroiliac joint injections provide statistically significant immediate and 1-week postinjection pain relief, no significant difference in the degree of pain relief achieved with intraarticular and periarticular injections was noted.
authors: 1 Department of Radiology and Medical Imaging, University of Virginia, 1218 Lee St, Box 800170, Charlottesville, VA 22908.
authors: Nicholas C
authors: NC
authors: Nacey
authors: 2 University of Virginia Public Health Sciences, Charlottesville, VA.
authors: James T
authors: JT
authors: Patrie
authors: 1 Department of Radiology and Medical Imaging, University of Virginia, 1218 Lee St, Box 800170, Charlottesville, VA 22908.
authors: Michael G
authors: MG
authors: Fox
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods*; D017116:Low Back Pain / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D015641:Radiography, Interventional; D012446:Sacroiliac Joint; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage*
chemical_list: D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D014221:Triamcinolone; D002045:Bupivacaine
keywords: bupivacaine; injection; intraarticular; pain; pain management; sacroiliac joint