Sacroiliac joint dysfunction

The sacroiliac joint is the junction between the sacrum and the ilium, and is located at the bottom of the spine. This joint is essential for the stability and function of the pelvic area and is composed of a series of ligaments and muscles that allow limited movement. It is a synovial joint, meaning it is covered by articular cartilage and has a joint capsule containing synovial fluid. Sacroiliac dysfunction can cause pain in the lower back, hips, and legs (see figure 1) and may result from injury, excessive strain, or muscle imbalance.
 

Figure 1: Referred pain pattern in lower extremities of sacroiliac joint dysfunction
 

Causes of Sacroiliac Joint Dysfunction
Sacroiliac dysfunction can be caused by several reasons, including:

• Traumatic injuries: A direct injury to the lower back, pelvis, or hip, such as a fall, car accident, or sports injury, can damage the sacroiliac joint and cause pain.
• Different leg lengths: Different leg lengths can alter the biomechanics of the sacroiliac joints and cause pain at this level.
• Joint wear and tear: Osteoarthritis, a degenerative disease that affects the joints, can also affect the sacroiliac joint. Wear and tear in this joint can cause pain, stiffness, and limited movement.
• Pregnancy: During pregnancy, hormones can soften the ligaments in the pelvis, which can cause pain in the sacroiliac joint and pelvis.
• Overload: Overload on the sacroiliac joint can lead to pain. This can be caused by intense physical activity or a sudden increase in physical activity.
•  Inflammatory or rheumatic diseases: These can cause selective inflammation of this joint, resulting in pain and functional limitation.

Diagnosing Sacroiliac Joint Dysfunction
Diagnosing sacroiliac joint dysfunction can be difficult, as the pain can be similar to that of other spinal and pelvic conditions. To determine if the pain is caused by the sacroiliac joint, sports trauma specialists often use a combination of the following:

• Medical history: The doctor will ask about the symptoms, duration and intensity of the pain, as well as any events or activities that may have triggered the pain.
• Physical examination: The doctor may perform physical tests to assess range of motion, muscle strength, and the presence of tender points.
• X-rays: X-rays can help detect abnormalities in the structure of the sacroiliac joint.
• Computed tomography (CT) or magnetic resonance imaging (MRI): These imaging tests can provide a detailed view of the sacroiliac joint and can help detect any injury or inflammation.
• Ultrasound-guided local anesthetic injection: If your doctor suspects that your pain is related to the sacroiliac joint, they may perform an anesthetic injection into the joint to determine if the pain temporarily disappears after the injection.

In some cases, additional testing may be necessary to rule out other causes of pain in the pelvis or spine. Once sacroiliac joint pain has been diagnosed, your doctor may recommend treatments to relieve symptoms.