Diagnosis

A clear understanding of the difference in the signs and symptoms of sacroiliac joint dysfunction and other pathologies is key in making the proper diagnosis. The diagnosis of sacroiliac joint dysfunction is made primarily from the patient’s subjective complaints and the physical evaluation; therefore, a diagnosis can be somewhat problematic for the clinician. Sacroiliac joint dysfunction does not usually show up on X-rays, MRI, or CT scans and so this makes it difficult to accurately diagnose. The most accurate way of determining whether the SI joint is a pain generator is to perform a diagnostic injection directly into the joint. Because the joint is so deep, this must be done using X-ray guidance with a fluoroscope. A numbing agent and steroid is injected directly into the joint. If the patient reports a drastic improvement in pain, then the physician may conclude that the SI joint is a pain generator.

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