A painful unknown: sacroiliac joint diagnosis and treatment

The sacroiliac joint (SIJ) is a complex anatomical structure located near the centre of gravity of the body. Micro-traumatic SIJ disorders are very difficult to diagnose and require a complete clinical and radiological examination. To diagnose micro-trauma SIJ pain it is recommended to have at least three positive provocative specific manoeuvres and then a radiologically controlled infiltration test. Conservative treatment combining physiotherapy and steroid injections is the most common therapy but has a low level of efficiency. SIJ thermolysis is the most efficient non-invasive therapy. SIJ fusion using a percutaneous technique is a solution that has yet to be confirmed on a large cohort of patients resistant to other therapies. Cite this article: EFORT Open Rev 2020;5:691-698. DOI: 10.1302/2058-5241.5.190081