Sacroiliac Dysfunction


Sacroiliac Dysfunction, Sacroiliac Joint Dysfunction, SI Joint Dysfunction, Sacroiliitis, Sacroiliac instability, Sacroiliac Ligament Sprain

  • Pathophysiology
  1. Bony Pelvis is tightly bonded at 3 joints (2 SI joints and Symphysis Pubis)
  2. Injury or inflammation of the joint formed between the Sacrum and the ilium
  3. Anterior and posterior ligaments supporting the SI joint tend to allow minimal laxity normally
  • Symptoms
  1. Low Back Pain localized to the SI joint
  2. Pain may be referred into the leg
  • Differential Diagnosis
  1. Lumbar Disc Disease
  2. Musculoskeletal Low Back Pain
  3. Septic Sacroiliitis (emergency)
    1. Presents with fever, limp and SI joint region pain
    2. Most common in children 0.5 to 4 years old and in adolescents
  4. Spondyloarthropathy causing Sacroiliitis
    1. Ankylosing Spondylitis
    2. Reactive Arthritis (e.g. Reiter's Syndrome)
    3. Inflammatory Bowel Disease with secondary Arthropathy
    4. Psoriatic Arthritis
  • Imaging
  1. Normal in most cases (unless underlying Spondyloarthropathy)
  • Management
  1. Physical therapy with mobilization techniques
  2. NSAIDs
  3. Consider SI Joint Corticosteroid Injection in refractory cases
  • References
  1. Madden (2010) Netter's Sports Medicine, Elsevier, Philadelphia, 402-3