The impact of intra-sacroiliac joint methylprednisolone injection in the recovery of patients with spondyloarthropathy: a randomized controlled trial.

Introduction: Spondyloarthropathies are a group of chronic inflammatory diseases with specific clinical symptoms in rheumatic diseases. These patients suffer from pain in the joints. Physicians have tried several ways to decrease the pain in these patients. This study aimed to evaluate the effect of intra-sacroiliac joint methylprednisolone injection under the guidance of ultrasonography in spondyloarthropathy patients.

Material and methods: In this randomized control trial we studied 60 patients with spondyloarthropathy (30 patients in the intervention group and 30 patients in the control group) from January 2020 to December 2020. The intervention group patients received 40 mg of intra-sacroiliac joint (SIJ) methylprednisolone injection at the beginning in addition to treatment with nonsteroidal anti-inflammatory drugs (inflammatory dose) and sulfasalazine (2 to 3 g/day). Patients' pain intensity and symptoms were assessed in the 2^nd, 4^th, 6^th, and 8^th weeks after glucocorticosteroid injection. Quantitative factors were compared by independent Student's t-test. Data analysis was performed using SPSS version 22.0 software. A p-value < 0.005 was considered significant.

Results: There were no statistically significant differences in Visual Analogue Scale (VAS) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) criteria and finger-to-floor (FTF) levels in the intervention and control groups. There were significant differences in VAS and BASDAI criteria and FTF levels 2 weeks after the injection, and this difference remained the same until the end of the 8^th week. The p-value was significant (p-value < 0.0001).

Conclusions: The sacroiliac joint methylprednisolone injection approach with ultrasound guidance seems to be effective in pain relief and function, and patient satisfaction scores. Additionally using the guidance of ultrasonography in this approach is without the risk of radiation exposure.