Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with localized pain in the sacroiliac region, often radiating to the buttock, groin, or posterior thigh. Pain is exacerbated by prolonged sitting, standing, or transitional movements such as rising from a chair or climbing stairs. No reported neurological deficits, saddle anesthesia, or bowel/bladder dysfunction.
Clinical Examination Findings
Physical examination reveals tenderness to palpation over the sacroiliac joint and the posterior superior iliac spine (PSIS). Provocative testing is positive for SI joint dysfunction, including positive FABER (Patrickโs) test, Gaenslenโs test, and Thigh Thrust maneuver. Gait analysis shows antalgic pattern secondary to pelvic instability. Neurological exam is intact with normal strength, sensation, and deep tendon reflexes.
Treatment Protocol
Initial management includes activity modification, physical therapy focusing on core stabilization and pelvic girdle strengthening, and non-steroidal anti-inflammatory drugs (NSAIDs). If conservative measures fail, consider sacroiliac joint corticosteroid injection under fluoroscopic guidance or radiofrequency ablation for chronic refractory cases.