Ultrasound-guided sacroiliac joint injection in patients with established sacroiliitis: precise IA injection verified by MRI scanning does not predict clinical outcome

被引:69
作者
Hartung, Wolfgang [1 ]
Ross, Christian J. [2 ]
Straub, Rainer [3 ]
Feuerbach, Stefan [2 ]
Schoelmerich, Juergen [3 ]
Fleck, Martin [1 ,3 ]
Herold, Thomas [2 ]
机构
[1] Asclepios Clin, Dept Rheumatol Clin Immunol, D-93077 Bad Abbach, Germany
[2] Univ Med Ctr Regensburg, Dept Radiol, Regensburg, Germany
[3] Univ Med Ctr Regensburg, Dept Internal Med 1, Regensburg, Germany
关键词
Sacroiliitis; Ultrasonography; Intra-articular injection; Spondyloarthritis; INTRAARTICULAR CORTICOSTEROID INJECTION; ANKYLOSING-SPONDYLITIS; SERONEGATIVE SPONDYLARTHROPATHY; FOLLOW-UP; PAIN; SPONDYLOARTHROPATHY;
D O I
10.1093/rheumatology/kep424
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Methods. Ultrasound-guided injections were performed with 40 mg triamcinolone and 0.78 mg gadolinium in 20 SIJ of 14 consecutive patients suffering from active sacroiliitis. Immediately following SIJ injection, MRI scanning was initiated to verify the correct placement of the drug. Clinical outcome of the intervention was determined using a numerical pain rating scale (NRS) at Days 1 and 28. Results. Despite ultrasound guidance, only 8 injections (40%) were exactly positioned into the SIJ space, whereas the other 12 injections (60%) missed the SIJ. However, there were no significant differences observed in the clinical outcome between the IA-injected group and the peri-articular-injected group. There was similar pain relief observed in both groups 24 h and 28 days following the intervention [IA injection group: mean NRS-baseline: 6.8 (range 4-9), NRS-24 h: 4.3 (range 1-7) and NRS-day 28: 3.5 (range 1-5); peri-articular injection group: mean NRS-baseline: 7.0 (range 5-10), NRS-24 h: 4.1 (range 1-10) and NRS-day 28: 4.5 (range 1-8)]. Conclusion. These results demonstrate that IA SIJ injections remain technically challenging despite ultrasound guidance. However, peri-articular deposition of triamcinolone appears sufficient for pain and symptom control in patients suffering from active sacroiliitis.
引用
收藏
页码:1479 / 1482
页数:4
相关论文
共 24 条
[1]   CT-guided intraarticular corticosteroid injection into the sacroiliac joints in patients with spondyloarthropathy: Indication and follow-up with contrast-enhanced MRI [J].
Bollow, M ;
Braun, J ;
Taupitz, M ;
Haberle, J ;
Reisshauer, BH ;
Paris, S ;
Mutze, S ;
Seyrekbasan, F ;
Wolf, KJ ;
Hamm, B .
JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 1996, 20 (04) :512-521
[2]   MACROSCOPIC AND MICROSCOPIC ANATOMY OF THE SACROILIAC JOINT FROM EMBRYONIC LIFE UNTIL THE 8TH DECADE [J].
BOWEN, V ;
CASSIDY, JD .
SPINE, 1981, 6 (06) :620-628
[3]  
Braun J, 1996, J RHEUMATOL, V23, P659
[4]   Ankylosing spondylitis [J].
Braun, Juergen ;
Sieper, Joachim .
LANCET, 2007, 369 (9570) :1379-1390
[5]   CLINICAL HISTORY AS A SCREENING-TEST FOR ANKYLOSING-SPONDYLITIS [J].
CALIN, A ;
PORTA, J ;
FRIES, JF ;
SCHURMAN, DJ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1977, 237 (24) :2613-2614
[6]   Fluoroscopy-guided sacroiliac joint injections [J].
Dussault, RG ;
Kaplan, PA ;
Anderson, MW .
RADIOLOGY, 2000, 214 (01) :273-277
[7]   MR imaging -: Guided corticosteroid-infiltration of the sacroiliac joints:: Pain therapy of sacroiliitis in patients with ankylosing, spondylitis [J].
Fritz, J ;
König, CW ;
Günaydin, I ;
Clasen, S ;
Kastler, B ;
Kötter, I ;
Claussen, CD ;
Pereira, PL .
ROFO-FORTSCHRITTE AUF DEM GEBIET DER RONTGENSTRAHLEN UND DER BILDGEBENDEN VERFAHREN, 2005, 177 (04) :555-563
[8]   Magnetic resonance imaging guided corticosteroid injection of sacroiliac joints in patients with spondylarthropathy.: Are multiple injections more beneficial? [J].
Günaydin, I ;
Pereira, P ;
Fritz, J ;
König, C ;
Kötter, I .
RHEUMATOLOGY INTERNATIONAL, 2006, 26 (05) :396-400
[9]  
Hansen Hans C, 2003, Pain Physician, V6, P155
[10]   Fluoroscopy-guided intraarticular corticosteroid injection into the sacroiliac joints in patients with ankylosing spondylitis [J].
Karabacakoglu, A ;
Karaköse, S ;
Özerbil, ÖM ;
Ödev, K .
ACTA RADIOLOGICA, 2002, 43 (04) :425-427