The diagnosis and treatment of sacroiliac joint abnormalities

The sacroiliac joint (SIJ) is a highly studied but controversial area of orthopaedic diagnosis and treatment. Previous literature suggests that injuries and degeneration follow the patterns of other joints, and much is understood about its anatomic relationships, biomechanics and presentation. Nevertheless, historical literature has not resulted in a consensus on a standard method of diagnosis, or agreement on nonsurgical or surgical management. The diagnostic injection, although helpful, may support the diagnosis when present, but does not replace a cautious physical examination or exploration of other important findings. New methods of imaging and surgical treatment are reminders that answers for this difficult problem may be on the horizon.