To determine whether you have a sacroiliac (SI) joint dysfunction, it's very important that you get the right diagnostic tests. Here are the most commonly accepted methods to diagnose SI joint dysfunction.
Sacroiliac joint dysfunction tests include discussing your history and pain experience, a physical examination, tests to rule out other sources of pain, like lumbar spine pain and hip pain, and these commonly accepted methods:
Your doctor may perform a series of provocative tests or exams to manipulate your joints or feel for tenderness over your SI joint. All of these can help establish a diagnosis.6,7,8,9,10 Provocative SI joint tests include:
In five different positions, your doctor will apply pressure to your hips, knees, and other areas to see which positions may cause discomfort or pain.
In addition, X-rays, a CT scan, or MRI may be helpful in diagnosis. It is also important to remember that more than one condition (like a disc or hip problem) can co-exist with SI joint problems and your doctor should check for other factors that may be causing symptoms.
The most widely used method to accurately determine the cause of SI joint pain is to inject the SI joint with pain medicine.
Fluoroscopic guided SI joint injection with:
Post-injection pain reduction:
During the SI joint injection procedure, a small amount of numbing medicine (a local anesthetic such as lidocaine) is injected into the SI joint under fluoroscopic guidance or CT guidance.
If the injection results in a significant decrease in SI joint pain (more than 50% pain relief) for an hour or two after the injection, then this is considered a positive or confirmatory diagnostic injection. This means your SI joint is most likely the cause of your pain.11
If the level of pain does not change after the injection, the SI joint is less likely to be the primary cause.
Studies show that the SI joint is a source of pain in 15-30% of patients with chronic low back pain. Do you have SI joint pain? Take this short 7-step quiz to find out.
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