Annals of Rehabilitation Medicine

Agreement and Sensitivity of Sacroiliac Joint Pain Provocation Tests.: Kim, Min Seok , Kim, Hee Sang , Ahn, Kyung Hoi; J Korean Acad Rehabil Med 1997;21(5):974-980.

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The purpose of this study is to assess agreement and sensitivity of sacroiliac joint pain provocation tests with fluoroscopically guided, diagnostic sacroiliac joint block.

Thirty patients with sacroiliac joint area pain and without other obvious sources of pain were selected. The patients were tested with 11 kinds of sacroiliac pain provocation tests before and after sacroiliac joint block and their pain relief scales were measured before block, after 30 minutes, 1 week, and 2 weeks.

According to pain relief scale at 30 minutes after sacroiliac joint block, the patients were divided into 3 groups - response group that was 100-70% pain relief; 9 cases(30%), partial response group that was 69-30% pain relief; 15 cases(50%), and nonresponse group that was 29-0% pain relief; 6 cases(20%). In the response and the partial response group, the sensitivity of pain provocation tests were 88.5% in FABERE, 53.9% in Erichen, 50.5% in Yeoman, 43.3% in Minor, and 38.5% in Gaenslen test. Gamma statistic for agreement in the 5 superior sensitive tests was 0.80 between Minor and Gaenslen test, 0.67 between Yeoman and Minor test, 0.48 between Yeoman and Gaenslen test, and 0.44 between FABERE and Minor test. Pain relief scale 2 weeks later were above 60% in response group and above 50% in partial and nonresponse group.

In conclusion, combining the FABERE test and another sensitive test, we enhance diagnostic power for sacroiliac dysfunction.

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Anatomic Study of Injection Point of Piriformis Muscle on Cadaver Study.: Min, Ji Hye , Choi, Eun Suk , Rhee, Won Ihl , Kim, Go Woon , Lee, Be Na; J Korean Acad Rehabil Med 2008;32(1):62-66.

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Objective: To identify the optimal site for piriformis muscle injection, using easily detectable sacroiliac joint as a landmark, under fluoroscopic guidance. Method: We examined the anatomic relationships of the sciatic nerve, piriformis muscle and sacroiliac joint in 18 buttocks from 9 cadavers. The distance from the inferior margin of the sacroiliac joint to the piriformis muscle at the crossing point with the sciatic nerve, and the width of the sciatic nerve at that point were measured. We assessed the depth of the piriformis muscle and the sciatic nerve using ultrasonography in asymptomatic controls. Results: The mean distance from the inferior margin of the sacroiliac joint to the piriformis muscle at the crossing point with the sciatic nerve was 15.7±3.4 (12∼22) mm laterally and 16.5±4.1 (10∼25) mm caudally. The mean width of the sciatic nerve at that point was 15.4±3.7 (12∼22) mm. Ultrasonographic findings revealed the mean distance as 4.48±0.49 cm from the skin to the surface of the piriformis muscle and as 5.68±0.62 from the skin to the surface of the sciatic nerve. Conclusion: The most optimal injection site for piriformis syndrome was located 15.6±3.4 (12∼22) mm laterally and 16.5±4.1 (10∼25) mm caudally from the inferior margin of the sacroiliac joint. (J Korean Acad Rehab Med 2008; 32: 62-66)

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Tuberculous Sacroiliitis.: Kim, Eun Jin , Shin, Ju Yon , Lee, Do Kyung; J Korean Acad Rehabil Med 2007;31(5):606-608.

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Tuberculosis can affect the sacroiliac joint. The involvement has been reported in up to 10 percent of patients with osteoarticular tuberculosis. The onset is usually insidious, and early diagnosis requires a high index of clinical suspicion. Lack of awareness of this presently uncommon form of infection often leads to diagnostic delay and increased morbidity. Early diagnosis and proper treatment with anti-tuberculous medication could obtain a satisfactory functional outcome. We report a case of tuberculous sacroiliitis in a 21 year-old male patient including his clinical presentation, radiographic features and outcome of medical treatment. (J Korean Acad Rehab Med 2007; 31: 606-608)