The current "gold standard" for diagnosis of sacroiliac joint dysfunction emanating within the joint is sacroiliac joint injection confirmed under fluoroscopy or CT-guidance using a local anesthetic solution. The diagnosis is confirmed when the patient reports a significant change in relief from pain and the diagnostic injection is performed on 2 separate visits. Published studies have used at least a 75 percent change in relief of pain before a response is considered positive and the sacroiliac joint deemed the source of pain.    However, several other injection studies have compared intra-articular with extra-articular injection, and indicate that the ligament injection behind the joint is oftentimes superior to injection in the joint and seems to be a very underutilized diagnostic tool.  
You are expected to arrive at the surgery center at least one hour before your procedure is scheduled. Bring a responsible adult driver with you because you will be receiving medications and this could impair your ability to drive. Do not eat or drink anything for 6 hours prior to your procedure. Please take your regularly scheduled blood pressure and heart medications with a sip of water as you normally would. If you have diabetes, take 1/2 of your nor8mal dosage and bring your insulin with you. After you arrive, you will be asked to sign in and complete any paperwork as needed. You will then be taken to the PreOp area. At this time, a nurse will ask you some questions and have you sign your consent forms. It is imperative that you, the patient, inform the nurse of any changes in your history and/or physical, such as the recent flu or have any health problems that might affect your procedure. Inform the staff if you are allergic to betadine. You will then be asked to change and then you will be assisted to the PreOp room or to a stretcher where your blood pressure, heart rate, temperature, and oxygen saturation will be done. An IV will be started (if ordered by your physician). Your belongings will be put away in a cabinet. The anesthetist will talk to you before your procedure. You will then be prepped and positioned. The physician will perform the procedure. You may be given medication before and/or during your procedure to help you relax. You may doze off during this time. Afterwards, the nurse will cleanse off the prepping solution and apply the dressings/bandages as needed. You will be transported to the recovery room area where you will be monitored anywhere from 20 minutes to an hour. When you are awake enough, you will be offered beverages and some crackers. After this, someone will take your IV out and help you get dressed. Lastly, your caretaker will be given discharge instructions for your care at home.
The effect of the steroid can last anywhere from several days to several months. The purpose of the injection is to decrease swelling and inflammation to decrease pain. Over time, your body may heal itself How many injections do I need? If the first injection does not relieve your symptoms after two weeks, a second injection may be recommended. If the second injection doesn’t relieve your symptoms after an additional two weeks, a third injection may be recommended. The effects of the injections are additive if spaced at these time intervals. We generally would not perform more than 3 steroid injections in a 6-month time period. More than this may increase the steroid load in your body increasing the likelihood of suffering from side effects. If 3 injections did not provide a lasting benefit, it is unlikely that any further steroid injections would provide further benefit What are the risks and side effects? Overall, the procedure is very safe. As with any procedure, there are risks. The most common side effect is pain, which is temporary. Any time a needle is punctured through the skin, there is a chance of bleeding or infection that is very rare. Other rare side effects include nerve damage or worsening of pain., which are extremely unlikely.