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Dr Hitesh Patel is Consultant – Pain Management & Palliative Care he recieved his M.D. from B.J. Medical College Ahmedabad, Asia’s largest hospital, Civil Hospital, Ahmedabad. He earned his F.I.P.M. (Fellow In Pain Management) at Daradia Pain Hospital in Kolkata, which is affiliated with the Aesculap Academy in Germany. He received his C.C.P.P.M. (Certificate Course in Pain and Palliative Medicine) from Gujarat Cancer Research Institute Ahmedabad, the state’s largest cancer hospital.

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Sacroiliac Joints

  • The joint between articular surfaces on the sacrum and iliac bones. (a diarthrodial synovial joint)
  • Only the anterior part is a true synovial joint.
  • The posterior part is fibrous tissue, with strong ligaments
  • It is stable, rigid, very strong, and reinforced by strong ligaments and muscles surrounding it
  • Relatively immobile (Does not have much motion2mm).
  • Transmits all the forces of the upper body to the pelvis (hips) and legs (effective load transfer)
  • Acts as a shock-absorbing structure.

Causes SI Joint Syndrome:

Risk Factor

  • leg length discrepancy
  • abnormal gait pattern
  • trauma
  • heavy physical exertion
  • pregnancy
  • scoliosis
  • lumbar and sacrum fusion surgery


  • IASP criteria for diagnosing SI joint pain
  • Pain present in the region of the SIJ
  • +ve Clinical SI Joint Stress tests(painful).
  • +ve diagnostic interventional procedure (completely relieves the pain)


>> It is often hard to distinguish from other types of LBP; because of the pattern of back and pelvic pain that mimic each other In SI joint syndrome we find:

  • Low back pain bilateral or unilateral in the posterior aspect of the SI joint
  • Unilateral Buttock, hip, or Thigh pain
  • Difficulty sitting in one place for too long due to pain
  • LBP with radiculopathy

>>   Medical imaging includes:

  • Radiography
  • Computed tomography (CT)
  • Single-photon emission CT
  • Bone scan
  • Nuclear imaging techniques
  • Magnetic resonance imaging (MRI) does not allow the evaluation of normal anatomy. However, in the presence of spondyloarthropathy, MRI can detect inflammation and destruction of cartilage despite normal clinical presentation

Diagnostic injection

  • The IASP criteria mandate that pain should disappear after intra-articular SI joint infiltration with a local anesthetic in order to confirm the diagnosis.


  • Physiotherapy, pharmacological 
  • Intraarticular sacroiliac joint injection therapy
  • Radiofrequency ablation

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