Sacroiliitis

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Original Editors - Charlotte Fastenaekels

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Search Strategy[edit | edit source]

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Definition/Description[edit | edit source]

Sacroiliitis is an inflammation of one or both sacroiliac joints, which can lead to inflammatory low back pain but sometimes patients remain asymptomatic. Sacroiliitis is linked to spondyloartropathies (a group of diseases) and it can be defined as a sacroiliac joint dysfunction, which seems to be in a state of altered mechanics. Pain caused by sacroiliitis can be related to either too much or not enough motion in the SI joint. That makes it less a pathological diagnosis and more a patho-mechanical diagnosis.[1][2]

Clinically Relevant Anatomy[edit | edit source]

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Epidemiology /Etiology[edit | edit source]

Spondyloartropathies: Ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis of chronic inflammatory bowel disease and undifferentiated spondyloarthropathy. Symmetrical sacroiliitis is found in more than 90% of ankylosing spondylitis and 2/3 in reactive arthritis and psoriatic arthritis. It is less severe and more likely to be unilateral and asymmetrical in reactive arthritis, psoriatic arthritis, arthritis of chronic inflammatory bowel disease and undifferentiated spondyloarthropathy. Also traumatic injuries, infections, inflammatory conditions like rheumatoid arthritis, degenerative joint diseases, metabolic conditions like gout and even pregnancy, sacroiliitis can occur in all of them.[1][3]

Characteristics/Clinical Presentation[edit | edit source]

Pain in the buttocks, lower lumbar and postero-lateral thigh region. It may extend down to one ore both legs, predominant unilateral pain inferior to the PSIS, groin pain (might not be a sensitive indicator). In some cases there are aggravating or improving factors but with no diagnostic value. Sometimes decreased or increased range of motion, but it may not be a useful predictor.[1][3]

Differential Diagnosis[edit | edit source]

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Diagnostic Procedures[edit | edit source]

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Outcome Measures[edit | edit source]

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Examination[edit | edit source]

Some individual provocation tests show sufficient inter-rater reliability. The following tests seem to have sufficient diagnostic accuracy: the FABER test, thigh thrust test and the hip abduction test. A complete physical examination with an excellent accuracy to diagnose sacroiliac joint related pain should involve a cluster of sacroiliac joint tests and a McKenzie evaluation.[2][3]

Medical Management
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Physical Therapy Management
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Key Research[edit | edit source]

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Resources
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Clinical Bottom Line[edit | edit source]

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Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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  1. 1.0 1.1 1.2 J. Braun, J. Sieper and M. Bollow, Review Article Imaging of Sacroiliitis, Section of Rheumatology, Department of Nephrology and Endocrinology, UK Benjamin Franklin, Free University, Berlin; Department of Radiology, UK Charite´ , Humboldt University, Berlin, Germany,©2000 Clinical Rheumatology
  2. 2.0 2.1 M. Monticone, A. Barbarino, C. Testi, S. Arzano, A. Moschi, S. Negrini, Evaluation of the Presence of Sacroiliac Joint Region Dysfunction Using a Combination of Tests: A Multicenter Intertester Reliability Study, Physical Therapy . Volume 82 . Number 8 . August 2002
  3. 3.0 3.1 3.2 Peter Huijbregts, PT, MSc, MHSc, DPT, OCS, MTC, FAAOMPT, FCAMT Sacroiliac joint dysfunction: Evidence-based diagnosis, Assistant Online Professor, University of St. Augustine for Health Sciences, St. Augustine, FL, USA, Consultant, Shelbourne Physiotherapy Clinic, Victoria, BC, Canada,Rehabilitacja Medyczna (Vol. 8, No. 1, 2004)