• Arman Taheri, Mahbod Lajevardi, Mohsen Abad, Jayran Zebardast, and Sanaz Shaabani.
• Department of Anesthesiology and Critical Care and Pain Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
• Pain Physician. 2018 Jan 1; 21 (1): 61-66.

BackgroundThe anatomic characteristics of the sacroiliac joint (SIJ) make it difficult to achieve intraarticular injection without radiologic guidance. The classic C-arm guided SIJ intervention technique is difficult. Here we describe a new and simple method for SIJ intraarticular intervention.ObjectiveThis study aims to introduce a new, simple approach for SIJ intraarticular intervention.Study DesignAn observational case series study.SettingThe study was conducted at an academic medical center in a major metropolitan city.MethodsThis method of intervention was performed on 57 patients (a total of 73 joints) who were selected for diagnostic and therapeutic SIJ intervention. The procedure was done in anteroposterior (AP) view, without any C-arm angulation. The accuracy of the intraarticular injection was confirmed by using intraarticular contrast material. A numerical rating scale (NRS) score was recorded for each joint before and after the procedure; the number of x-ray exposures and number of attempts were recorded for each procedure as well.ResultsSuccessful intraarticular contrast spread was obtained in all SIJs. The number of x-ray exposures was about 9 ± 3, and there was not a remarkable difference between cases according to gender of the patient (P = 0.1) or side of the joint (P = 0.2). In 5 cases, the first needle placement was not correct; there were no differences between gender (P = 0.4) and side of the joint (P = 0.4) regarding the first successful attempt. The NRS pain scores decreased in all of the patients more than 50% after the procedure; the pain scores were similar to the results of classic methods of intraarticular interventions with successful contrast spread, and there were no remarkable differences considering gender (P = 0.5) or side of the joint (P = 0.8).LimitationsThis is a very small, nonrandomized, and controlled study; further blinded clinical trials are needed to clarify the probable advantages of this method compared with conventional ones.ConclusionThis observational study introduces a new and simple approach for SIJ intraarticular intervention, with a high success rate.Key WordsLow back pain, sacroiliac joint, C-arm, new technique, intraarticular, injection.

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