Intraarticular injections (ultrasound-guided and fluoroscopic-guided approaches)

Intraarticular injection of the sacroiliac joint is a commonly performed procedure in interventional pain practice for the management of chronic low back pain due to sacroiliac joint inflammation or dysfunction. It can also be done as a diagnostic procedure to detect the source of low back pain. It is preferred to perform this procedure under image guidance using either fluoroscopy or ultrasound. Ultrasound-guided injection of the sacroiliac joint is preferred in pregnant patients to avoid exposure and risk of complications from radiation. Ultrasound is also beneficial in avoiding vascular injury; however, this imaging modality has less accuracy than fluoroscopy. This chapter describes the steps used to successfully perform two approaches, providing information about the necessary equipment, patient positioning, and anesthesia.