Name of the Procedure:

Common name(s): SI Joint Injection
Technical term: Injection Procedure for Sacroiliac Joint; Arthrography (HCPCS G0259)

Summary

This procedure involves injecting a contrast dye into the sacroiliac (SI) joint, located where the spine meets the pelvis, to visualize the joint under imaging. This is typically followed by an injection of a medication to reduce inflammation and pain.

Purpose

The procedure is used to diagnose and manage pain originating from the SI joint, which can result from conditions such as sacroiliitis, arthritis, or trauma. It aims to relieve pain and improve joint function.

Indications

This procedure is indicated for patients experiencing:

• Unexplained lower back pain
• SI joint pain or inflammation
• Pain that radiates to the buttocks, hips, or legs
• Inability to sit or stand for prolonged periods

Preparation

Patients may be instructed to:

• Avoid eating or drinking for a few hours before the procedure
• Adjust certain medications, especially blood thinners
• Undergo prior imaging tests (e.g., MRI, CT scans) for accurate diagnosis

Procedure Description

1. The patient lies face down on an examination table.
2. The targeted SI joint area is cleaned and sterilized.
3. A local anesthetic is applied to numb the injection site.
4. Using fluoroscopy (live X-ray), a needle is guided into the SI joint.
5. A contrast dye is injected to visualize the joint.
6. Once the needle position is verified, a corticosteroid and/or anesthetic medication is injected to reduce inflammation and pain.

Duration

The procedure typically takes 30-60 minutes.

Setting

The procedure is usually performed in an outpatient clinic, radiology department, or hospital setting.

Personnel

• Radiologist or pain management specialist
• Nurse or medical assistant
• Radiologic technician

Risks and Complications

Potential risks include:

• Infection at the injection site
• Bleeding or bruising
• Increased pain
• Allergic reaction to the contrast dye or medication
• Nerve damage (rare)

Benefits

Patients can expect:

• Pain relief, which may be immediate or take a few days to manifest
• Improved joint mobility and function
• Enhanced ability to perform daily activities

Recovery

Post-procedure care includes:

• Rest for the first 24 hours
• Applying ice to reduce swelling
• Avoiding strenuous activities for a few days
• Follow-up appointments to monitor progress

Alternatives

Other treatment options include:

• Physical therapy
• Oral pain medications or anti-inflammatory drugs
• Radiofrequency ablation
• Surgery, such as SI joint fusion Each alternative has its own benefits and drawbacks compared to the injection procedure.

Patient Experience

During the procedure, patients might feel mild discomfort or a sensation of pressure. After the procedure, they may experience soreness at the injection site, which can be managed with over-the-counter pain relievers and ice packs.