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Joint Bone Spine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le dimanche 30 juin 2019
Doi : 10.1016/j.jbspin.2019.06.003
accepted : 4 June 2019
Local sacroiliac injections in the treatment of spondyloarthritis. What is the evidence?

Daniel Wendling a, b,
a Department of Rheumatology, University Teaching Hospital, CHRU de Besançon, boulevard Fleming, 25030 Besançon, France 
b EA4266, EPILAB, Université Bourgogne Franche-Comté, 25030 Besançon, France 

Department of Rheumatology, University Teaching Hospital, CHRU de Besançon, boulevard Fleming, 25030 Besançon, France.Department of Rheumatology, University Teaching Hospital, CHRU de Besançonboulevard FlemingBesançon25030France

Local sacroiliac injections represent an available treatment option in spondyloarthritis (SpA). There is no synthetic data about efficacy of this procedure in SpA. The aim of this review is to analyze the available data of the literature of local sacroiliac injections in SpA.


A Pubmed search of papers published after 1990 was performed.


Pubmed search retained 15 publications in spondyloarthritis, 12 with corticosteroids (total of 468 injections in 268 patients), including 2 small-sized controlled studies, and 3 with TNF blockers (24 patients in open studies). With steroids, the two controlled studies (with a total number of 30 patients only) demonstrated significant results over placebo. In open studies, good response was reported in more than 80% of the cases, with a mean duration of improvement over 8 months. Reduction of sacroiliac inflammation on MRI was also found in several studies after injection. There is no consensus about the technique of injection or the type of steroid injected. No particular safety concern was reported. Many limitations have to be considered in the interpretation of these results.


This kind of procedure should be kept in the therapeutic armament in the current setting of costly targeted systemic treatments of spondyloarthritis. However, definition of a clear position in the treatment strategy needs further well-conducted studies.

The full text of this article is available in PDF format.

Keywords : Spondyloarthritis, Treatment, Sacroiliac joint, Intra-articular injection, Steroids, Anti-TNF agents

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