SI Joint dysfunction requires appropriate interpretation of a patient’s history, clinical exam results, and imaging studies. Often hip pathology and lumbar pathology coexists with SI Joint pathology. During physical examination, patients with SI Joint dysfunction exhibit any/all of the following symptoms:
- Low back pain
- Palpable tenderness of the posterior pelvic SI region
- Provocative maneuvers to the hip (i.e. Faber test) and the absence of neurologic deficit
- Joint asymmetry may be seen on CT and MRI.
When the SI Joint is suspected as the source of the patient’s low back pain, confirmation is provided by CT or fluoroscopic guided injection. This injection is the diagnostic “Litmus test.” If Lidocaine is injected into the joint and symptoms temporarily resolve, this is confirmation of the SI Joint as the source of the patient’s low back pain.
Once confirmed, treatment for SI Joint dysfunction has heretofore been limited to NSAID prescriptions, physical therapy, chiropractic/osteopathic manipulations, muscle rehabilitation, and steroid injections. In some cases, these yield fair short-term relief, but symptom recurrence is the rule with SI Joint dysfunction. Until now, a permanent solution has not been an option for the patient.
