الفهرس 
ANATOMICAL, BIOMECHANICAL, AND PATHOPHYSIOLOGICALOnly 14 pages are availabe for public view
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Abstract
The sacroiliac joint (SIJ) is a complex joint, and an integral component of the spinal axial support system. The interre-lationship of the SIJ with the lumbar spine and lower extremities places this joint as a pivotal and key interface that requires stability for optimal ambulatory and functional capacity.
The SIJ has for long been overlooked as a potential pain-generator. However, as a result of accumulating evidence, there has been a resurgence of interest in the SIJ as a source of chronic infra-gluteal and lower extremity pain.
Chronic SIJ pain and dysfunction could be seen as a clinical entity with a constellation of symptoms and signs, for which the term ‘Sacroiliac Joint Syndrome’ has been coined.
Although the SIJ may be involved in a range of arthritic disorders, or be affected by traumatic, infective or iatrogenic pathologies, the most common form of the SIJ syndrome is by far primary or ‘idiopathic’ SIJ dysfunction.
Diagnosis of SIJ dysfunction is one of the most intricate tasks a chronic pain therapist may encounter. Because of limitations of the history, physical examination, and imaging modalities, fluoroscopically guided or CT-guided, contrast-enhanced blocks are the only method for definitively diagnos¬ing or refuting the SIJ as a source of pain.
The importance of treating a dysfunctional SIJ cannot be overstressed, in order to avoid ensuing pain and disability. In this respect, a multidisciplinary approach to treatment should ideally be pursued. This entails the integrated efforts of the pain physician, physical therapist, social psychologist, and pain interventionalist. For the occasional patient with intractable and disabling pain, neurosurgical or orthopedic intervention may be embarked upon.
To sum up, The SIJ is an under-estimated, and often ignored, compo¬nent of spinal axial pain that will not divulge its contribution to pain with routine bed¬side tests. A multidisciplinary approach, therefore, should be sought for diagnosis and treatment of SIJ pain and dysfunction. In this regard, the pain interventionalist has got a firm stand in deciphering the enigma of the SIJ syndrome.