Comparing the Effects of Ultrasound Versus Fluoroscopy for Sacroiliac Joint Injections

"* Needle entry point is in the lower one-third of the SIJ~* Sterile preparation (with chlorhexidine) and draping and 3 mL of 1% lidocaine injected subcutaneously at site of needle entry~* Under fluoroscopy guidance, Havel's Inc. EchoStim (facet tip) 21 Gauge 4 needle is inserted in a coaxial fashion into the SIJ~* 1 mL of contrast (iohexol 300 mg/mL) is injected to outline the SIJ and to ensure no vascular uptake~* Injection of 20 mg of triamcinolone diluted in 4 mL of 1% lidocaine~* Patient observed in recovery bay for 20 minutes and then discharged home"

"* Sterile preparation (with chlorhexidine) and drape~* Using ultrasound guidance (SonoSite S-nerve) with a low frequency (2-5 Hz) curvilinear transducer in a sterile cover, the transducer is placed in a transverse plane over the SIJ and needle entry point is chosen at the medial end of the ultrasound transducer~* 3 mL of 1% lidocaine is injected subcutaneously at site of needle entry~* Under ultrasound guidance, a Havel's Inc. EchoStim (facet tip) 21 Gauge 4 needle is inserted in a medial to lateral direction and guided into the SIJ. (0.5-2 mL of normal saline may be injected during needle insertion to locate tip of needle and to ensure solution does not spill out onto sacrum).~* After using the Doppler function to identify any surrounding vessels (to avoid intravascular injection), 20 mg of triamcinolone diluted in 4 mL of 1% lidocaine is injected.~* Patient observed in recovery bay for 20 minutes and then discharged home"