Fluoroscopically guided sacroiliac joint injections: Comparison of the effects of intraarticular and periarticular injections on immediate and short-term pain relief

Nicholas C. Nacey, James T. Patrie, Michael Fox

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective. The purpose of this study was to determine whether intraarticular sacroiliac joint injections provide greater immediate and short-term pain relief than periarticular sacroiliac joint injections do. MATERIALS AND METHODS. The records of all fluoroscopically guided sacroiliac joint injections performed over a 4-year period were identifed. Patients who received an injection of 0.5 mL of bupivacaine and 0.5 mL (20 mg) of triamcinolone and who had preinjection, immediate, and 1-week postinjection pain scores (0-10 numeric scale) were included. Images from the procedures were retrospectively reviewed by two musculoskeletal radiologists to determine intraarticular or periarticular administration of the injection with discrepancies resolved by consensus. RESULTS. One hundred thirteen injections in 99 patients (65 women, 34 men; mean age, 59.4 years) met the inclusion criteria. There were 55 intraarticular and 58 periarticular injections. The mean preinjection, immediate, and 1-week postinjection pain scores for the intraarticular injections were 6.0, 1.6, and 4.1 and for the periarticular injections were 6.1, 2.0, and 4.2. The mean immediate and 1-week postinjection pain reduction were statistically signifcant in both groups (p < 0.001). After adjustment for age, sex, preinjection pain score, time of year, and indication for injection, no signifcant difference in the preinjection to immediately postinjection change in pain between intraarticular and periarticular injections (mean change, 0.37; p = 0.319) or in the preinjection to 1-week postinjection change in pain (mean change, 0.06; p = 0.888) was noted. The mean fluoroscopy times were 42.4 seconds for intraarticular injections and 60.5 seconds for periarticular injections (p = 0.32). CONCLUSION. Although both intraarticular and periarticular sacroiliac joint injections provide statistically signifcant immediate and 1-week postinjection pain relief, no signifcant difference in the degree of pain relief achieved with intraarticular and periarticular injections was noted.

Original languageEnglish (US)
Pages (from-to)1055-1061
Number of pages7
JournalAmerican Journal of Roentgenology
Volume207
Issue number5
DOIs
StatePublished - Nov 1 2016
Externally publishedYes

Fingerprint

Sacroiliac Joint
Intra-Articular Injections
Pain
Injections
Triamcinolone
Fluoroscopy
Bupivacaine
Consensus

Keywords

  • Bupivacaine
  • Injection
  • Intraarticular
  • Pain
  • Pain management
  • Sacroiliac joint

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{5a367628376f46eabf76aeedfc090a2e,
title = "Fluoroscopically guided sacroiliac joint injections: Comparison of the effects of intraarticular and periarticular injections on immediate and short-term pain relief",
abstract = "Objective. The purpose of this study was to determine whether intraarticular sacroiliac joint injections provide greater immediate and short-term pain relief than periarticular sacroiliac joint injections do. MATERIALS AND METHODS. The records of all fluoroscopically guided sacroiliac joint injections performed over a 4-year period were identifed. Patients who received an injection of 0.5 mL of bupivacaine and 0.5 mL (20 mg) of triamcinolone and who had preinjection, immediate, and 1-week postinjection pain scores (0-10 numeric scale) were included. Images from the procedures were retrospectively reviewed by two musculoskeletal radiologists to determine intraarticular or periarticular administration of the injection with discrepancies resolved by consensus. RESULTS. One hundred thirteen injections in 99 patients (65 women, 34 men; mean age, 59.4 years) met the inclusion criteria. There were 55 intraarticular and 58 periarticular injections. The mean preinjection, immediate, and 1-week postinjection pain scores for the intraarticular injections were 6.0, 1.6, and 4.1 and for the periarticular injections were 6.1, 2.0, and 4.2. The mean immediate and 1-week postinjection pain reduction were statistically signifcant in both groups (p < 0.001). After adjustment for age, sex, preinjection pain score, time of year, and indication for injection, no signifcant difference in the preinjection to immediately postinjection change in pain between intraarticular and periarticular injections (mean change, 0.37; p = 0.319) or in the preinjection to 1-week postinjection change in pain (mean change, 0.06; p = 0.888) was noted. The mean fluoroscopy times were 42.4 seconds for intraarticular injections and 60.5 seconds for periarticular injections (p = 0.32). CONCLUSION. Although both intraarticular and periarticular sacroiliac joint injections provide statistically signifcant immediate and 1-week postinjection pain relief, no signifcant difference in the degree of pain relief achieved with intraarticular and periarticular injections was noted.",
keywords = "Bupivacaine, Injection, Intraarticular, Pain, Pain management, Sacroiliac joint",
author = "Nacey, {Nicholas C.} and Patrie, {James T.} and Michael Fox",
year = "2016",
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doi = "10.2214/AJR.15.15779",
language = "English (US)",
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T1 - Fluoroscopically guided sacroiliac joint injections

T2 - Comparison of the effects of intraarticular and periarticular injections on immediate and short-term pain relief

AU - Nacey, Nicholas C.

AU - Patrie, James T.

AU - Fox, Michael

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Objective. The purpose of this study was to determine whether intraarticular sacroiliac joint injections provide greater immediate and short-term pain relief than periarticular sacroiliac joint injections do. MATERIALS AND METHODS. The records of all fluoroscopically guided sacroiliac joint injections performed over a 4-year period were identifed. Patients who received an injection of 0.5 mL of bupivacaine and 0.5 mL (20 mg) of triamcinolone and who had preinjection, immediate, and 1-week postinjection pain scores (0-10 numeric scale) were included. Images from the procedures were retrospectively reviewed by two musculoskeletal radiologists to determine intraarticular or periarticular administration of the injection with discrepancies resolved by consensus. RESULTS. One hundred thirteen injections in 99 patients (65 women, 34 men; mean age, 59.4 years) met the inclusion criteria. There were 55 intraarticular and 58 periarticular injections. The mean preinjection, immediate, and 1-week postinjection pain scores for the intraarticular injections were 6.0, 1.6, and 4.1 and for the periarticular injections were 6.1, 2.0, and 4.2. The mean immediate and 1-week postinjection pain reduction were statistically signifcant in both groups (p < 0.001). After adjustment for age, sex, preinjection pain score, time of year, and indication for injection, no signifcant difference in the preinjection to immediately postinjection change in pain between intraarticular and periarticular injections (mean change, 0.37; p = 0.319) or in the preinjection to 1-week postinjection change in pain (mean change, 0.06; p = 0.888) was noted. The mean fluoroscopy times were 42.4 seconds for intraarticular injections and 60.5 seconds for periarticular injections (p = 0.32). CONCLUSION. Although both intraarticular and periarticular sacroiliac joint injections provide statistically signifcant immediate and 1-week postinjection pain relief, no signifcant difference in the degree of pain relief achieved with intraarticular and periarticular injections was noted.

AB - Objective. The purpose of this study was to determine whether intraarticular sacroiliac joint injections provide greater immediate and short-term pain relief than periarticular sacroiliac joint injections do. MATERIALS AND METHODS. The records of all fluoroscopically guided sacroiliac joint injections performed over a 4-year period were identifed. Patients who received an injection of 0.5 mL of bupivacaine and 0.5 mL (20 mg) of triamcinolone and who had preinjection, immediate, and 1-week postinjection pain scores (0-10 numeric scale) were included. Images from the procedures were retrospectively reviewed by two musculoskeletal radiologists to determine intraarticular or periarticular administration of the injection with discrepancies resolved by consensus. RESULTS. One hundred thirteen injections in 99 patients (65 women, 34 men; mean age, 59.4 years) met the inclusion criteria. There were 55 intraarticular and 58 periarticular injections. The mean preinjection, immediate, and 1-week postinjection pain scores for the intraarticular injections were 6.0, 1.6, and 4.1 and for the periarticular injections were 6.1, 2.0, and 4.2. The mean immediate and 1-week postinjection pain reduction were statistically signifcant in both groups (p < 0.001). After adjustment for age, sex, preinjection pain score, time of year, and indication for injection, no signifcant difference in the preinjection to immediately postinjection change in pain between intraarticular and periarticular injections (mean change, 0.37; p = 0.319) or in the preinjection to 1-week postinjection change in pain (mean change, 0.06; p = 0.888) was noted. The mean fluoroscopy times were 42.4 seconds for intraarticular injections and 60.5 seconds for periarticular injections (p = 0.32). CONCLUSION. Although both intraarticular and periarticular sacroiliac joint injections provide statistically signifcant immediate and 1-week postinjection pain relief, no signifcant difference in the degree of pain relief achieved with intraarticular and periarticular injections was noted.

KW - Bupivacaine

KW - Injection

KW - Intraarticular

KW - Pain

KW - Pain management

KW - Sacroiliac joint

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