Fluoroscopic Guided Sacroiliac Joint Steroid Injection for Low Back Pain in a Patient with Osteogenesis Imperfecta

Abstract

Background: Osteogenesis imperfecta, also known as `brittle bonedisease', is a genetic connective tissue disease. It is characterized bybone fragility and osteopenia (low bone density). In this case, a57-year old female presented to the University Hospital of the WestIndies (UHWI), Physical Medicine and Rehabilitation Clinic with left lowback pain rated 6/10 on the numeric rating scale (NRS). Clinically, thepatient had sacroiliac joint-mediated pain although X-rays did not showthe sacroiliac joint changes. Fluoroscopy-guided left sacroiliac jointsteroid injection was done.Methods: Numeric rating scale and Oswestry Disability Index (ODI)questionnaire were used to evaluate outcome. This was completed atbaseline, one week follow-up and at eight weeks post fluoroscopyguidedsacroiliac joint steroid injection.Results: Numeric rating scale improved from 6/10 before the procedure to0/10 post procedure, and ODI questionnaire score improved from amoderate disability score of 40% to a minimal disability score of 13%.Up to eight weeks, the NRS was 0/10 and ODI remained at minimaldisability of 15%.Conclusion: Fluoroscopy-guided sacroiliac joint injection is a knowndiagnostic and treatment method for sacroiliac joint mediated pain. Toour knowledge, this is the first case published on the use offluoroscopy- guided sacroiliac joint steroid injection in the treatmentof sacroiliac joint mediated low back pain in a patient withosteogenesis imperfecta.