A 74 year old gentleman was seen in the Pain Clinic.
On examination, he had a reduction in flexion, extension and lateral movement. He was tender more on the right than on the left sacroiliac joint and also had some tenderness in L5/S1 bilaterally. He was taking Paracetamol and anti-inflammatory medication.
One of the options suggested to him was to have x ray guided injections of his sacroiliac joints. He was very unsure about this as he was not keen on having any needles put inside him! On balance he finally, but reluctantly, agreed to have this done. The sacroiliac joints were injected under x ray guidance under aseptic technique with gloves, gown, Chlorhexidine, local anaesthetic to the skin, and a total of 15 mls of Bupivacaine 0.5% and 80 mg of Depo-Medrone was administered.
This gentleman was seen 3 months later in the Pain Clinic and was very pleased to report a great improvement in his previous low back pain. He was discharged from the clinic but has the option to return should his symptoms return.