Sacroliitis (Sacroiliac Arthritis), A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

Sacroiliitis is a medical disorder of any inflammation in the sacroiliac joint located where the lower spine and pelvis are connected.
Sacroiliitis is often found as part of a feature of inflammatory disorders of the spinal column.
Considered as a group, these disorders are termed a "spondyloarthropathy" and have disorders such as ankylosing spondylitis, psoriatic arthritis, and reactive arthritis, among others.
Sacroiliitis may also be a disorder of other types of arthritis, such as ulcerative colitis, Crohn's disease, or osteoarthritis.
Sacroiliitis can produce pain in the buttocks or lower back, and can radiate down one or both legs
Prolonged standing or stair climbing can make the pain worse.
Causes:

1. Spondyloarthropathy
   This group of inflammatory bone disorders consisting of ankylosing spondylitis, arthritis linked with psoriasis, and other rheumatologic diseases, such as lupus can cause sacroiliitis
2. Arthritis
   Any wear-and-tear arthritis (osteoarthritis) can occur in sacroiliac joints.
3. Traumatic injury
   A sudden impact, such as a motor vehicle accident or a fall, can injure the sacroiliac joints.
4. Pregnancy
   The sacroiliac joints must loosen and stretch to provide room for childbirth.
5. Infection of the sacroiliac joint
   In rare cases, the sacroiliac joint can become infected.
   a. Osteomyelitis (infection of the bone) can occur in other bones and spread to the sacro-iliac joint
   b. Urinary tract infection due to its proximity to the sacroiliac joint can spread to the joints.
   c. Endocarditis (infection of the heart valves) may also pass an infected blood clot through the blood to the sacroiliac joint
   d. IV drug use or drug addiction
   Symptoms
   Pain and stiffness in the lower back, thighs or buttocks, particularly in the morning or when sitting for a long duration of time
   Pain that worsens with walking because the swinging movement of the hips stretches and strains the sacroiliac joints
   Diagnosis
   The medical history and physical examination are important to arriving at an accurate medical diagnosis and plan of treatment.
   CT and MRI scan may be done to better reveal the adequacy of the spinal canal and surrounding structures.
   CT scan may also have myelography, which requires an x-ray contrast dye injected into the spinal column to show issues such as a bulging disc or bone spur pressing on the spinal cord or nerves.
   If such an anesthetic injection into the sacroiliac joint stops the pain, it is likely that the cause is in the sacroiliac joint.
   Treatment
   Treatment is dependent on the signs and symptoms, and the cause of the sacroiliitis.
   In most patients rest, anti-inflammatory medicine, and physical therapy relieve symptomology.
   Physical therapy should direct on mobilization (exercise and manipulation by the therapist), and stabilization (muscle strengthening).
   Pain relievers
   If over-the-counter pain medicines do not provide adequate relief, the doctor may prescribe stronger types of these drugs.
   Muscle relaxants.
   Medicines such as cyclobenzaprine (Amrix, Fexmid) might help decrease the muscle spasms often linked with sacroiliitis.
   Tumor necrosis factor (TNF) inhibitors
   These medicines block a cell protein (cytokine) that works as an inflammatory agent.
6. Etanercept (Enbrel),
7. Infliximab (Remicade),
   Blocking the TNF cytokine may help decrease pain, stiffness and tender or swollen joints.
   They often help alleviate symptoms of sacroiliitis that is also linked with ankylosing spondylitis.
   Disease-modifying anti-rheumatic drugs (DMARDs).
   These medicines are sulfasalazine and methotrexate.
   Sacroiliac joint injections of steroid under fluoroscopic guidance
   Sacroiliac joint fusion surgery and denervation

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