Comparative analysis of fluoroscopic-guided and ultrasound-guided sacroiliac joint injection in patient with clinical sacroiliitis

Abstract

Background: The complex anatomy of sacroiliac joint (SIJ) mandates an imaging modality to perform the diagnostic or therapeutic joint injection. Methods: Thirty-eight patients with sacroiliitis were randomly allocated into two groups, and were given SIJ injection using either fluroscopy (FL) or ultrasound (USG) as a guide to intervene. The assessment of pain by numerical rating scale (NRS), psychological and quality of life assessment by Depression Anxiety Stress Scale (DASS) and Oswestry Disability Index (ODI), respectively, learning curve evaluation by the number of attempts, time taken and subjective ease of performing the procedure were evaluated. Results: Decreased numerical rating score (NRS) of pain from preprocedure mean value of 7.39 ± 0.20–0.94 ± 0.15 in the FL grp and 7.22 ± 0.21 to 2.78 ± 0.32 in the USG group at 4 weeks was significant and comparable (P < 0.001). The improvement in DASS from 40.78 ± 1.96–22.78 ± 0.49 (P < 0.001) in FL grp and 41.33 ± 1.62–25.22 ± 0.73 (P < 0.001) in USG group were significant and comparable after 12 weeks' follow-up. ODI decreased from 45.44 ± 0.99–20.78 ± 0.84 (P < 0.001) and 46.33 ± 0.98–24.11 ± 0.95 (P < 0.001) in FL and USG grp after 12 weeks. Fluoroscopic procedure took 1–3 attempts compared to 2–4 for USG. The average time taken to perform fluoroscopic intervention was 6.89 ± 0.23 min as compared to 9.32 ± 0.87 min by USG. Conclusion: USG and FL both are effective tools to intervene the SIJ but USG requires greater skill.

Keywords

• fluoroscopy
• low back pain
• sacroiliac joint
• sacroiliitis
• ultrasonography