Sacroiliitis is a common cause of low back and buttock pain. Intra-articular steroid injection of the sacroiliac joint can provide pain relief and functional improvement. This randomized controlled trial aims to compare the outcomes of ultrasound-guided versus fluoroscopic-guided sacroiliac joint steroid injections in patients with sacroiliitis. The study will evaluate procedural success, pain reduction, and functional improvement using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) at follow-up intervals.
Age 18-70 years
Both sexes
Clinical diagnosis of sacroiliitis
Prior SI joint injection in the past 12 months
Contraindication to corticosteroid injection (systemic infection, local infection, bleeding diathesis, uncontrolled diabetes with HbA1c >9%, allergy to contrast or steroid)
Radicular or neurogenic pain attributable to lumbar spine or hip pathology
Pregnancy or breastfeeding
Parallel
Ultrasound-guided intra-articular steroid injection
Procedure/SurgeryParticipants will receive intra-articular sacroiliac joint steroid injection under ultrasound guidance. A needle will be advanced under real-time ultrasound guidance to the sacroiliac joint, and 40 mg triamcinolone acetonide mixed with 1 mL 0.25% bupivacaine will be injected.
Procedural success rate of sacroiliac joint injection
Successful intra-articular deposition of steroid in the sacroiliac joint confirmed by the respective imaging guidance modality (ultrasound or fluoroscopy).
Oswestry Disability Index (ODI) Score
The Oswestry Disability Index (ODI) is a validated patient-reported outcome measure used to assess disability related to low back pain. Scores range from 0 to 100, with higher scores indicating greater disability and worse functional status.
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