Feasibility of ultrasound-guided sacroiliac joint puncture in the treatment of inflammatory and osteoarthritis pain: a 11-years single-centre experience
4 affiliations
- 1Rheumatology Department, Ramón y Cajal University Hospital, Madrid, Spain
- 2Servicio de Reumatología, Hospital Universitario Asisa Moncloa, Madrid, Spain
- 3Department of Medicine, Faculty of Medicine, Health and Sports, Universidad Europea de Madrid, Madrid, Spain
- 4Rheumatology Department, Blua Valdebebas Sanitas Hospital, Madrid, Spain
Abstract
Background: Sacroiliac joint inflammation is a key manifestation of spondyloarthritis; however, most sacroiliac pain arises from mechanical overload, which also involves an inflammatory component. Ultrasound-guided sacroiliac joint puncture (SJP) for local corticosteroid injection is a semi-invasive procedure infrequently performed in rheumatology clinics, despite previous reports describing its feasibility and relative simplicity.
Objective: To describe the clinical outcomes and safety of ultrasound-guided sacroiliac joint puncture (SJP) in patients with osteoarthritis (OA) or spondyloarthritis (SpA), and to identify independent predictors of clinical improvement.
Methods: We conducted a retrospective study including 130 patients who underwent 155 ultrasound-guided SJP procedures. Demographic variables were analysed per patient, whereas clinical outcomes were analysed per procedure. Improvement, no change/no report and worsening were obtained from follow-up clinical records. A complementary patient-level analysis restricted to the first procedure per patient was performed. Multivariable logistic regression was used to evaluate independent predictors of improvement.
Results: The mean age of the cohort was 48.7 years. Clinical improvement was observed in 130 procedures (83.9%), 23 (14.8%) showed no change or no report, and 2 (1.3%) were associated with worsening. Improvement rates differed significantly between diagnostic groups: 75.6% in OA and 92.2% in SpA (p < 0.01). In the multivariable model, diagnosis was the only independent predictor of improvement, with SpA showing higher odds of response compared with OA (adjusted OR 4.22, 95% CI 1.22–14.58, p = 0.023). Obesity, fibromyalgia, age and sex were not independently associated with outcome. The patient-level analysis yielded similar results.
Conclusion: Ultrasound-guided SJP is a safe procedure associated with high rates of clinical improvement. Patients with SpA show significantly greater benefit than those with OA, and this association remains robust after multivariable adjustment. Underlying inflammatory disease appears to be a key determinant of therapeutic response.
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BibTeX
@article{guillenastete2026feasibility,
title = {{Feasibility of ultrasound-guided sacroiliac joint puncture in the treatment of inflammatory and osteoarthritis pain: a 11-years single-centre experience}},
author = {Carlos A. Guillén-Astete and Samantha Kanaffo and África Andreu-Suarez and Claudia Urrego-Laurín and Boris Blanco-Cáceres and Pablo A. Zurita-Prada},
journal = {Frontiers in Medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1997507},
url = {https://doi.org/10.3389/fmed.2026.1997507},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Feasibility of ultrasound-guided sacroiliac joint puncture in the treatment of inflammatory and osteoarthritis pain: a 11-years single-centre experience
AU - Carlos A. Guillén-Astete
AU - Samantha Kanaffo
AU - África Andreu-Suarez
AU - Claudia Urrego-Laurín
AU - Boris Blanco-Cáceres
AU - Pablo A. Zurita-Prada
PY - 2026
DA - 2026/10/22
JO - Frontiers in Medicine
DO - 10.3389/fmed.2026.1997507
UR - https://doi.org/10.3389/fmed.2026.1997507
AB - Background: Sacroiliac joint inflammation is a key manifestation of spondyloarthritis; however, most sacroiliac pain arises from mechanical overload, which also involves an inflammatory component. Ultrasound-guided sacroiliac joint puncture (SJP) for local corticosteroid injection is a semi-invasive procedure infrequently performed in rheumatology clinics, despite previous reports describing its feasibility and relative simplicity. Objective: To describe the clinical outcomes and safety of ultrasound-guided sacroiliac joint puncture (SJP) in patients with osteoarthritis (OA) or spondyloarthritis (SpA), and to identify independent predictors of clinical improvement. Methods: We conducted a retrospective study including 130 patients who underwent 155 ultrasound-guided SJP procedures. Demographic variables were analysed per patient, whereas clinical outcomes were analysed per procedure. Improvement, no change/no report and worsening were obtained from follow-up clinical records. A complementary patient-level analysis restricted to the first procedure per patient was performed. Multivariable logistic regression was used to evaluate independent predictors of improvement. Results: The mean age of the cohort was 48.7 years. Clinical improvement was observed in 130 procedures (83.9%), 23 (14.8%) showed no change or no report, and 2 (1.3%) were associated with worsening. Improvement rates differed significantly between diagnostic groups: 75.6% in OA and 92.2% in SpA (p < 0.01). In the multivariable model, diagnosis was the only independent predictor of improvement, with SpA showing higher odds of response compared with OA (adjusted OR 4.22, 95% CI 1.22–14.58, p = 0.023). Obesity, fibromyalgia, age and sex were not independently associated with outcome. The patient-level analysis yielded similar results. Conclusion: Ultrasound-guided SJP is a safe procedure associated with high rates of clinical improvement. Patients with SpA show significantly greater benefit than those with OA, and this association remains robust after multivariable adjustment. Underlying inflammatory disease appears to be a key determinant of therapeutic response.
SN - 2296-858X
ER -