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Sacroiliitis

Definition


Disease: Sacroiliitis Sacroiliitis
Category: Bones, joints, muscles diseases

Disease Definition:

The inflammation of one or both of the sacroiliac joints that connect the lower spine and pelvis is called sacroiliitis. In case someone has sacroiliitis, the smallest movement of the spine will cause pain or make the person extremely uncomfortable.

 

Diagnosing sacroiliitis could be difficult because this condition could be mistaken for other causes of low back pain, such as a herniated disk, strained muscles or sciatica. A group of diseases called spondyloarthropathies, which cause inflammatory arthritis of the spine, could be associated with sacroiliitis.

 

A combination of rest, physical therapy and medications are the options for treating sacroiliitis.
 

Work Group:


Symptoms, Causes

Symptoms:

Some of the signs and symptoms of sacroiliitis may be:

 

  • An inflammatory skin condition known as psoriasis.
  • Pain and stiffness in the lower back, buttocks or thighs.
  • Pain radiating down the leg
  • Decreased range of motion
  • Pain that worsens with walking because the motion of the hips strains the sacroiliac joints
  • A fever that appears quickly
  • Inflammation in one or both of the eyes (iritis or uveitis)
  • Limping
     

Causes:

Sacroiliitis could be due to several factors, such as: 

Spondyloarthropathies:

Arthritis associated with psoriasis, and ankylosing spondylitis are included in this group of diseases.

Infection of the sacroiliac joint:

A number of infections could cause this condition, leading to sacroiliitis.        

Degenerative arthritis:

Degeneration of the sacroiliac joints is caused by degenerative arthritis, which is also called osteoarthritis of the spine, causing mild inflammation and pain.

A traumatic injury or sudden impact:

In case a fall or a motor vehicle accident affects someone’s spine, lower back, buttocks or pelvic, sacroiliitis may occur.

Pregnancy:

Pregnancy may end up causing sacroiliitis, because the pelvis has to stretch to accommodate childbirth.

 

Some of the factors that could increase someone’s risk of getting sacroiliitis include:

 

  • A history of bone, joint or skin infections
  • Urinary tract infection, which could spread to the sacroiliac joints from the kidneys, bladder and urethra.
  • Endocarditis, the infection of the heart's inner lining, which could spread to the sacroiliac joints.
  • Illicit drug use
     

Complications

Complications:

Serious damage could be caused to the sacroiliac joints due to delayed treatment of sacroiliitis, which could be because the person has put off going to the doctor, or because of an incorrect diagnosis.

 

Ankylosing spondylitis is a larger inflammatory arthritis. Sacroiliitis could be a part of this condition. Spine deformities, heart problems, difficulty breathing and lung infections are some of the serious complications that could result from this condition.
 

Treatments:

Treatment of sacroiliitis will be based on its underlying condition, in addition to the signs and symptoms that the patient is experiencing. Some of the medications that could be used to treat this condition include:

Corticosteroids:

Inflammation and pain could be reduced by these medications, which could also slow joint damage. The effect of corticosteroid injections could last for months, which could be used for localized pain relief. Some examples of these medications include methylprednisolone and prednisone.

The long-term use of these medications could cause some serious side effects, despite the fact that they could make a person feel dramatically better for a short time. Corticosteroids are usually prescribed to relieve acute symptoms, and their dose is gradually decreased. Cataracts, a round face, an increased risk of infection, thinning of the bones, weight gain and easy bruising are some of the side effects of these medications.

However, people with ankylosing spondylitis are more susceptible to developing osteoporosis. There's also no definitive evidence that oral steroids will help people with sacroiliitis associated with ankylosing spondylitis.

NSAIDs:

Swelling and inflammation could be reduced by these pain-relieving drugs, which include naproxen and indomethacin. Depending on the severity of the condition, the patient may be prescribed these medications on an as-needed basis, or continuously.
Stomach bleeding and indigestion are some of the side effects of these nonsteroidal anti-inflammatory drugs. Additionally, high blood pressure and liver and kidney damage are some of the potential side effects of these medications. People who have pre-existing medical conditions, such as heart or liver disease, the risk of these side effects are higher. In addition to all these, NSAIDs, except for aspirin, also increase the risk of cardiovascular events, such as stroke or heart attack.

TNF inhibitors:

A cell protein called cytokine that acts as an inflammatory agent is blocked by these tumor necrosis factor inhibitors. This helps in reducing pain, stiffness, and tender or swollen joints. Only after trying other treatments for at least three months without success will these medications be considered, because they're expensive. Some examples include adalimumab, infliximab and etanercept.

DMARDs:

These disease-modifying antirheumatic drugs are prescribed to limit joint damage. To slow the disease and save the joints as well as other tissues from permanent damage, it's quite important to take these drugs at the early stages in the development of a joint condition.
These medications are usually taken with a corticosteroid or an NSAID because they work slowly. The NSAID or corticosteroid will treat the patient’s immediate symptoms and limit inflammation, while the DMARD will modify the disease itself. Even though sulfasalazine, which is a DMARD, is currently considered not to be effective for people with the spinal symptoms associated with ankylosing spondylitis, however, it could be quite helpful in treating arthritis of the leg and arm joints. Methotrexate is another DMARD, but to determine whether it could be used in treating sacroiliitis related to ankylosing spondylitis or not, more studies are needed.

 

PHYSICAL THERAPY:

To help manage pain and stiffness, the patient should also rest and undergo physical therapy. To maintain joint flexibility, he/she will learn range-of-motion and stretching exercises, and to give the muscles additional stability he/she will learn strengthening exercises.
 

Prognosis:

Not available

Expert's opinion

Expert's Name:
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Expert's opinion:

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Clinical Trials:

Not available

 

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