Ultrasound-guided intra-sacroiliac joint injection — methylprednisolone versus triamcinolone: a randomized comparative study

Background
The sacroiliac joint (SIJ) has been considered as a pain generator in about 10% to 25% of patients with leg or low back pain. The current study was conducted to compare the effectiveness of ultrasound-guided intra-articular SIJ injection of methylprednisolone versus triamcinolone acetonide according to postinjection pain relief, the random blood glucose (RBG) level in diabetic patients, quality of life (QoL), patient’s satisfaction, and the analgesic requirement.
Results
NRS was better at rest and at motion in MTP groups 3 (2–3) and 4 (3–5) compared to TMC groups 4 (3–5) and 5 (3–6) at 2 weeks after injection with statistically significant difference equal 0.025 and 0.036, respectively, while there was no statistically significant difference between the studied groups at 1, 2, and 3 months after injection. The RBG level was higher in the MTP group in the 1st, 2nd, and 3rd days after injection 206 (168–308), 245 (200–385), and 215 (179–343) compared to the TMC group 170 (136–271), 168 (119–233), and 166 (110–253) with statistically significant difference equal 0.066, 0.045, and 0.049, respectively. However, there was no statistically significant difference in the RBG level at baseline, 4th, 5th, 6th, and 7th days after injection between the two studied groups. Moreover, there was a statistically significant elevation in the RBG level within the MTP group in the first 3 days compared to the baseline ( ˂ 0.001). There was no statistically significant difference according to QoL, patient’s satisfaction, and the analgesic requirement between both groups.
Conclusions
SIJ injection with methylprednisolone or triamcinolone acetonide showed an improvement in pain score, while the MTP group was better in NRS at 2 weeks. Also, the RBG level in diabetic patients was higher in the MTP group in the 1st, 2nd, and 3rd days after injection. There was upgrading in QoL, similarity in patient’s satisfaction, and reducing the use of analgesia with no statistically significant difference between the studied groups.