Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed
CPT4 code
Name of the Procedure:
Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed. Commonly referred to as a SI Joint Injection.
Summary
A SI Joint Injection is a minimally invasive procedure used to relieve pain in the sacroiliac (SI) joint by delivering medication directly to the affected area. The injection includes anesthetic and steroid drugs and is performed under image guidance like fluoroscopy or CT for precision.
Purpose
This procedure aims to alleviate pain and inflammation in the sacroiliac joint, which connects the lower spine to the pelvis. It can lead to improved mobility and decreased pain. It's often used for diagnostic purposes to determine if the SI joint is the pain source.
Indications
- Chronic lower back pain suspected to originate from the SI joint
- Pain in the buttocks, lower back, or legs
- Difficulty standing, walking, or sitting for prolonged periods
- Rheumatoid arthritis or ankylosing spondylitis affecting the SI joint
Preparation
- Patients may be advised to fast for a few hours prior to the procedure.
- Any blood-thinning medications may need to be adjusted.
- Pre-procedure imaging studies like MRI or X-ray may be required to assess the condition of the SI joint.
Procedure Description
- The patient lies face down on the procedure table.
- The skin over the SI joint is cleaned and sterilized.
- Local anesthesia is applied to numb the injection site.
- Using image guidance such as fluoroscopy or CT, a needle is inserted into the SI joint.
- A contrast dye may be injected to confirm proper needle placement.
- A mixture of anesthetic and steroid medication is injected into the joint.
- The needle is removed, and a small bandage is applied to the injection site.
Duration
The procedure typically takes around 20-30 minutes.
Setting
The SI Joint Injection is usually performed in a hospital, outpatient clinic, or surgical center.
Personnel
- Radiologist or pain management specialist
- Nurses or medical assistants
- Radiologic technologist for imaging guidance
Risks and Complications
- Localized pain or discomfort at the injection site
- Bleeding or infection
- Allergic reaction to the contrast dye or medication
- Rarely, nerve damage or worsening of symptoms
Benefits
- Relief from pain and inflammation in the SI joint
- Improved mobility and function
- Quick recovery with minimal downtime
Recovery
- Most patients can resume normal activities immediately or within a day of the procedure.
- Instructions may include avoiding strenuous activity for 24 hours.
- Follow-up appointments to assess the effectiveness of the injection and plan further treatment if needed.
Alternatives
- Physical therapy and exercises
- Oral anti-inflammatory medications or pain relievers
- Radiofrequency ablation or other minimally invasive procedures
- Surgical options in severe cases
- Pros and cons of each alternative should be discussed with the healthcare provider.
Patient Experience
- Patients may feel a brief sting or pressure during the injection.
- Temporary numbness or weakness in the legs may occur due to the anesthetic.
- Pain relief can be immediate, but it may take a few days to feel the full effect of the steroid.
- Comfort measures and pain management options are available to address any post-procedure discomfort.