First Spanish study on the effectiveness of ultrasound-guided sacroiliac joint injection in patients with spondyloarthritis

Rheumatol Adv Pract. 2022 May 23;6(2):rkac036. doi: 10.1093/rap/rkac036. eCollection 2022.

Abstract

Objective: The aim was to assess clinical improvement after US-guided injection of CSs into the SI joint of patients with SpA.

Methods: This was an observational, descriptive, retrospective study of patients with SpA and sacroiliitis who received an US-guided injection into the SI joint between 1 June 2020 and 31 May 2021. Means were compared using Student's paired t-test for the variables visual analog scale (VAS), BASDAI, ASDAS, CRP and ESR before and after the procedure. We evaluated the association between these variables and the clinical response using the odds ratio.

Results: We analysed 32 patients with SpA [age 42.69 (8.19) years; female sex, 56.25%], with a VAS score of 7.88 (0.79), BASDAI of 5.43 (1.48) and ASDAS of 3.27 (0.86) before the procedure. At 2-3 months, 75% of patients had improved: VAS 3.81 (2.33) (-4.07, P < 0.0001) and BASDAI 3.24 (1.6) (-2.19, P < 0.0001). At 5-6 months, 59.37% had improved: VAS 4.63 (2.31) (-3.25, P < 0.0001), BASDAI 3.57 (1.67) (-1.86, P < 0.0001) and ASDAS 2.27 (0.71) (-1.0, P < 0.0001). Bone marrow oedema resolved in 87.5% of cases compared with the previous MRI scan. No significant association was identified with the clinical response to the injection.

Conclusion: US-guided injection of CSs into the SI joint of patients with SpA and active sacroiliitis leads to an improvement in symptoms that is maintained at 5-6 months. The procedure is effective, safe, inexpensive and easy to apply.

Keywords: disease activity; sacroiliitis; spondyloarthritis; ultrasound-guided injection.