The Role of Corticosteroid Injections in the Treatment of Sacroiliitis: A Narrative Review.

IF 1.5 Q3 RHEUMATOLOGY Musculoskeletal Care Pub Date : 2024-09-01 DOI:10.1002/msc.1932

Peter D Vu, Aila Malik, Alexa Ryder, Ovie Enaohwo, Greg Blazek, Jason W Chen

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Abstract

Objectives: Axial spondyloarthritis (axSpA) is a chronic rheumatic, musculoskeletal, inflammatory disease with a propensity to present as sacroiliitis, which manifests as low back, buttock, or thigh pain. Effective primary management of axSpA requires a comprehensive approach specific to each patient and disease severity. Non-pharmacological measures form the cornerstone of treatment. With refractory disease, management also consists of local periarticular and intraarticular injections. The use of sacroiliac joint (SIJ) corticosteroid injections for the treatment of axSpA and localised inflammation, however, is a continuously burgeoning management option. This narrative review aims to present consolidated findings and summarise previously unreferenced or recently available evidence regarding corticosteroid injections to the SIJ for treating sacroiliitis and axSpA.

Methods: A comprehensive literary review with the following electronic databases was searched: MEDLINE via PubMed, Web of Science, Cochrane Library, and EMBASE.

Results: The initial search yielded a total of 126 references. After duplicates were removed and the remainder analysed for inclusion criteria, 7 studies were included. To stratify each study, injection methodology and characteristics were defined.

Discussion: The use of SIJ corticosteroid injections can be an appropriate and effective treatment option for refractory axSpA. The studies presented in this review reported a general trend towards a reduction in pain severity after SIJ corticosteroid injections. Because of the complexity and heterogeneity of the anatomy of the SIJ, image guidance is recommended when performing SIJ injections. Image-guided injections seem to produce better outcomes when compared to anatomic landmark-guided injections.

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皮质类固醇注射在骶髂关节炎治疗中的作用：叙述性综述。

目的：轴性脊柱关节炎（axSpA）是一种慢性风湿性、肌肉骨骼炎症性疾病，易表现为骶髂关节炎，表现为腰背、臀部或大腿疼痛。要对axSpA进行有效的初级治疗，就必须针对每位患者和疾病的严重程度采取综合方法。非药物治疗措施是治疗的基础。对于难治性疾病，治疗还包括局部关节周围注射和关节内注射。然而，使用骶髂关节（SIJ）皮质类固醇注射治疗axSpA和局部炎症是一种不断发展的治疗方法。这篇叙述性综述旨在介绍综合研究结果，并总结以前未引用或最近获得的有关骶髂关节注射皮质类固醇治疗骶髂关节炎和轴索硬化症的证据：方法：通过以下电子数据库进行了全面的文献综述检索：方法：通过 PubMed、Web of Science、Cochrane Library 和 EMBASE 对以下电子数据库进行了全面的文献综述检索：MEDLINE：结果：初步检索共获得 126 篇参考文献。结果：初步检索共获得 126 篇参考文献，去除重复文献并对剩余文献进行纳入标准分析后，共纳入 7 篇研究。为了对每项研究进行分层，对注射方法和特征进行了定义：讨论：对于难治性axSpA，使用SIJ皮质类固醇注射是一种适当而有效的治疗选择。本综述中的研究报告显示，SIJ皮质类固醇注射后，疼痛严重程度普遍呈减轻趋势。由于 SIJ 解剖结构的复杂性和异质性，建议在进行 SIJ 注射时使用图像引导。与解剖地标引导下的注射相比，图像引导下的注射似乎能产生更好的效果。

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来源期刊

Musculoskeletal Care RHEUMATOLOGY-

CiteScore

2.30

自引率

7.70%

发文量

期刊介绍： Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.