yogabook / pathologie / sacroiliitis

sacroiliitis

Definition

Sacroiliitis is an inflammation of the SI joint. It can occur acutely due to overloading and incorrect loading and heal quickly or, especially in the autoimmunological form, it can be chronically progressive and can lead to ankylosis. The disease can be divided into degrees:

0	normal ISG
1	suspicious changes of the ISG
2	Definitive minimal changes in the form of (circumscribed areas with erosions or sclerosis), unchanged width of the joint space
3	Pronounced erosions or sclerosis, widened or narrowed joint space, partial ankylosis
4	Complete ankylosis

Cause

The most important diseases are autoimmunological in nature:

1. Ankylosing spondylitis
2. Reiter’s disease (reactive arthritis)
3. Behcet’s disease
4. Psoriatic arthritis
5. CED(ulcerative colitis and Crohn’s disease)

Non-autoimmunological factors are also possible:

1. Chronic overloading and incorrect loading, also due to overweight or leg length discrepancy
2. Activated SI joint arthrosis
3. Gravidity: due to widening of the ligaments and increased partial body weight supported by the SI joint
4. traumatic: fall or accident with trauma to the region
5. Immigrated regional infection, e.g. infection in the UGT tract

Predisposition

1. HLA-B27 (autoimmunological form)
2. Activities involving fast or heavy lifting, especially if it is asymmetrical
3. Bony degeneration of the SI joint

Diagnosis

1. The diagnosis can usually be made on the basis of the symptoms, a detailed medical history and a few tests.
2. Tests and signs: stool rise test, Yeoman test, Menell test

Symptoms

1. Deep-seated, pressing or pulling low back pain, buttock pain, especially in the morning, better after movement. Mainly pain on movement, pain at rest also possible to a lesser extent
   Pain may radiate into the back or leg
2. Painful restriction of movement and limitation of movement due to inflammation caused by adhesion, stiffening
3. Typical pain triggers are
   • Transition from sitting to standing
   • Standing or walking for long periods of time
   • Climbing stairs
   • Large steps
   • turning over while lying down
   • Uncoordinated steps and kicks, jumps

Complications

1. especially in the autoimmunological form: Ankylosis, arthrosis

Therapy

1. Exercise reduction, sports break
2. Anti-inflammatory gels or oral administration, intra-articular injection
3. PT, Taping
4. Elimination or reduction of muscular imbalances