Sacroiliac disease is high-impact trauma to the sacroiliac joint that can cause death,
or bone, and nerve damage.
General information about Sacroiliac disease
The sacroiliac joint is a strong, weight bearing synovial joint between the ilium and
sacrum bones of the pelvis. The bones are held in place and allowed limited movements by a
system of sacroiliac ligaments. Relaxation of this and other joints and ligaments is
important during pregnancy and is accomplished by a special hormone called relaxin.
Usually the sacroiliac is damaged by high-impact injuries. These injuries may be life
threatening and mortality is approximately 20% if neighboring structures are
also damaged. Injuries to this area often includes neurological deficits. Dislocation and
nerve damage are frequently missed in the diagnosis.
Causes of Sacroiliac disease
The primary cause of dislocations, fractures, and accompanying damage is usually a
traumatic accident. Patients receiving such injuries require emergency medical attention.
There may be severe blood loss due to breakage of large bones and resuscitative measures
may be required for stabilization.
Diagnosis of Sacroiliac disease
The diagnosis can be difficult since nerve damage can mimic other conditions with
similar symptoms (i.e., low back pain in persons with sciatica).
Additionally imaging studies and physical examination maneuvers will miss the
diagnosis. The definitive method for diagnosing sacroiliac pathology would be injection of
local anesthetic in the correct area of the affected sacroiliac joint. This procedure is
usually performed using advance guidance systems (CT or fluoroscopic assisted guidance).
If the pain is relieved by anesthetic injection, then the diagnosis is confirmed.
There are three typical patterns of pain: pain directly over the joint, pain in the groin
extending down the affected leg that can mimic the signs associated with a herniated
lumbar disc, and pain widely dispersed in the affected leg.
Treatment of Sacroiliac disease
Treatment initially can include emergency interventions, but usually is conservative.
Treatment includes physical therapy, manipulation, and medications for pain control. In
some cases a sacroiliac belt can help with symptoms. In sacroiliac joint disease that has
already progressed and is chronic and severe, corrective joint fusion may be indicated.