Sacroiliitis, a chronic and rarely diagnosed pain

When there is chronic pain in the lower back that extends to the legs and there is an inflammatory compromise of the sacroiliac joints, the doctor may have diagnosed you, thanks to an MRI, a sacroiliitis.This disease has been part of the diagnosis of so-called spondyloarthropathies since its inclusion in the Rome criteria in 1961. Currently, with a simple magnetic resonance, its evolution and the treatment to be followed according to the age of the patient can be seen, but it is not always easy to reach your diagnosis.Chronic inflammatory low back pain can lead to suspect that it is not only the back that hurts, but that there are radiological changes, either unilateral or bilateral in the worst of cases, showing possible ankylosing spondylitis. This diagnosis is not frequent and in fact, it takes about 8 years to be confirmed. Often not only does it go unnoticed but it is also confused with other low back pain of different etiology.

The sacroiliac joint usually has pain that is found in the posterior superior iliac spine and usually radiates to the buttock. Generally, patients are prevented from performing physical activities and their daily life worsens and complains when they are mostly standing. Walking on uneven surfaces, making daily movements or taking weight, is impossible when trying to move the lower back.

Certainly patients feel relief when they sit down due to the relaxation of the hamstring muscles and the so-called dull pain is oppressive as if it were a stab wound. It can last for minutes or it can be persistent when it occurs suddenly due to a sudden movement.

The prevalence of sacroiliac joint pain is not well studied, there are numerous etiologies for this pain and the causes can be divided into intra-articular and extra-articular. For the physical examination, there is a series of 12 tests. The treatment to address sacroiletitis can be divided into conservative, interventional where it can be used from infiltration with local anesthetic and steroid to radiofrequency and finally surgical for selected cases. It is advisable to go to a rheumatologist to rule out other types of diseases and it must be remembered that neither a traumatologist nor a rehabilitator will be able to give the precise diagnosis. This type of arthralgia compromises the rheumatological area and should be studied in case the patient also has rheumatoid arthritis or spondyloarthritis,

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