Acute Sacroiliac Joint Pain: Clinical Presentation, Causes, and Investigations

Purpose of Review This review focuses on the clinical approach to acute sacroiliac joint (SIJ) pain, to improve clinicians' ability to identify key features of SIJ-related pain syndromes, risk factors, and underlying etiologies. We review anatomy, common presentations, and etiologies for SIJ pain and its mimics as well as evaluate the workup of SIJ pain. Recent Findings Despite numerous physical exam maneuvers which put stress on the SIJ, no one test is best to identify SIJ as the etiology of pain. Fluoroscopic-guided injection may prove to be a technique helpful in distinguishing this poorly understood joint. Summary Given the complexity of the SIJ anatomy and its inter-individual variation and changes with age, a thorough history, physical exam, and appropriate workup with laboratory studies and imaging will help guide clinicians to properly evaluate SIJ pathology etiology.