Computed tomography findings in patients with sacroiliac pain

Clin Orthop Relat Res. 2001 Jan;(382):112-8. doi: 10.1097/00003086-200101000-00017.

Abstract

This retrospective study evaluated the diagnostic value of computed tomography in patients with sacroiliac pain. Computed tomography scans of the sacroiliac joints of 62 patients with sacroiliac joint pain were reviewed. The criteria to include the patient in the current study were pain relief after a local injection in the sacroiliac joint under computed tomography guidance, a physical examination consistent with a sacroiliac origin of the pain, and negative magnetic resonance imaging of the lumbar spine. A control group consisted of 50 patients of matched age who had computed tomography scans of the pelvis for a reason other than pelvic or back pain. Computed tomography scans showed one or more findings in 57.5% and 31% of the sacroiliac joints in the symptomatic and the control groups, respectively. The computed tomography scans were negative in 37 (42.5%) symptomatic sacroiliac joints with a positive sacroiliac joint injection test. The sensitivity of computed tomography was 57.5 % and its specificity was 69%. The finding of the current study suggests limited diagnostic value of computed tomography in sacroiliac joint disease because of its low sensitivity and specificity. With clinical suspicion of a sacroiliac origin of pain, intraarticular injection is currently the only means to confirm that diagnosis.

MeSH terms

  • Adolescent
  • Adult
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / therapeutic use
  • Ankylosis / diagnostic imaging
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / therapeutic use
  • Arthralgia / diagnostic imaging*
  • Arthralgia / drug therapy
  • Betamethasone / administration & dosage
  • Betamethasone / therapeutic use
  • Bone Cysts / diagnostic imaging
  • Case-Control Studies
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Injections, Intra-Articular
  • Lidocaine / administration & dosage
  • Lidocaine / therapeutic use
  • Lumbar Vertebrae / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Osteosclerosis / diagnostic imaging
  • Physical Examination
  • Radiography, Interventional
  • Retrospective Studies
  • Sacroiliac Joint / diagnostic imaging*
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed*

Substances

  • Anesthetics, Local
  • Anti-Inflammatory Agents
  • Glucocorticoids
  • Betamethasone
  • Lidocaine