Very well explained presentation about the problems of sacroiliac joints. What about the cure for such different situations? Do some exercises will help in some cases or one needs invasive surgery in some other situations? Or should we live with the pain?
Exercises are helpful for many of these problems. While exercises and occasional painkillers are recommended for osteitis condensans and degeneration due to anatomical variants, it is now believed that stronger medication must be prescribed for axial spondyloarthritis, in parallel with physiotherapy. You should consult a rheumatologist.
What should I ask my Dr to do? I have had si joint pain that came right after my l5 s1 fusion. Xray noted osteoarthritis in both si joints one year after the lumbar fusion . Si pain continues daily but newest xray now says no si issues noted, but subchondral sclerosis in both hips. Plans were being made to treat the si joints but now I don't trust the diagnosis?
In order to answer your question we might need to review your images. Please follow this link, fill in the information and drag/drop your images onto the form. public.berlincaseviewer.com/askdrkay
What is the rhomboid skin depression on the sacroiliac joint area, which is slightest darker than the rest of the skin? That same area hurts. Would that be an infection, or…?
We always welcome guests here in our department. However, first schedule an appointment with a skilled rheumatologist who should double check your situation.
Hi, I understand you're not interested in providing me with a second opinion of my MRI scans. I just wonder if there's a way how to distinguish between sacroiliitis, Ankylosing spondylitis and bone marrow cancer, because all of these pathologies appear as high signal in bone marrow "oedema" on MRI - T2 - STIR sequence the same. Is there any pattern that can distinguish between bone marrow inflammation and cancer of the bone marrow in sacroiliac joint and iliac bone? Or only trepanobiopsy can tell? Regards
@berlincaseviewer Thank you so much dear professor, I know you are extremely busy with your clinical work, and I appreciate your help. I will upload the images or ask someone to help me, because, I'm not an expert on image and data transfer. Martin
My doctor told me that an MRI will not show ligament damage, is that true? I’ve had undiagnosed SI joint/hip pain for 3+ years. I’ve had many MRI’s done and they are all normal. Physical therapy and manipulation help for a few days, but then my pelvis feels out of alignment again. Do you think there’s possibly an issue with my ligaments?
MRIs are perfectly suitable for visualizing ligaments. It is important that a specialized radiologist looks at the images for the complex pain syndrome you have described. We are available for a second opinion. Upload the images here: cases.berlincaseviewer.com/secondopinion
Usually, damage in the SI joint can be seen easily on CT or MRI scans. Dynamic contrast-enhanced MRI was promoted in the late 1990ies but did not prove useful in clinical routine over time.
@@berlincaseviewer Thank you. I had different answers about, thus somebody affirmed that high damaged SI joint would be detected by MRI than others. I would just understand about a hypermobile SI joint, where its movement can provoke sciatic nerve symptom s (numbness at random various leg levels, those expire by itself after some time) according to posture maintained (pelvic tilt in particular). Thank you.
