Inflammation of the Sacroiliac Joint and Hip Joint

A lesser-known inflammatory joint disease that can significantly impact the lives of those affected is sacroiliitis. This condition involves inflammation of the sacroiliac joint, which is located at the lower part of the spine, where the sacrum meets the pelvic bones. The sacroiliac joint plays a crucial role in providing stability to the pelvis and anchoring it to the spine.

Symptoms of sacroiliitis often lead to sleepless nights, as patients report experiencing lower back pain in the early morning hours, which may improve with movement. Early diagnosis is essential for managing this condition, as inflammatory processes can arise from various causes, and the selection of appropriate therapy depends on a clear understanding of the underlying factors.

What is the sacroiliac joint and what role does it play in our body?

The sacroiliac joint is located on either side of the spine, situated between the sacrum (the triangular bone at the base of the spine) and the ilium (the uppermost part of the pelvic bone). This joint is relatively stable, as the bones within it can only shift minimally in relation to one another during movement. The primary function of the sacroiliac joint is to stabilize the pelvis and connect it to the spine, aided by a strong ligamentous system surrounding the pelvis.

The stability of the sacroiliac joint is particularly important during walking and various sports, as it absorbs loads and allows for dynamic movements. To ensure the connection between the pelvis and spine, the sacroiliac joint plays a key role in the body’s biomechanics.

Causes and triggers of sacroiliitis

The causes of sacroiliitis can be diverse. The most common factors include injuries, such as accidents affecting the pelvis, which can mechanically induce inflammation. Additionally, pregnancy, deep skin infections, and certain infections like endocarditis or intravenous drug use can increase the risk of developing sacroiliitis.

Another common cause of inflammation may be an autoimmune reaction, where the body’s immune system mistakenly attacks the sacroiliac joint. This process is often triggered by a combination of genetic predisposition and environmental factors, such as viral infections. As a result of autoimmune inflammation, the inflammatory processes can affect not only the sacroiliac joint but also other small joints in the spine.

Symptoms and diagnosis of sacroiliitis

The most characteristic symptom of sacroiliitis is lower back pain that occurs in the early morning or at night, which in many cases is so intense that it wakes the affected person from sleep. The pain may ease if the individual changes their body position or moves in the morning. During inflammatory processes, patients often report stiffness and restricted movement, which develop due to the pain.

To establish a diagnosis, doctors first examine the location and nature of the pain, followed by a physical examination to check for tenderness in the joint. Imaging studies, such as X-rays or MRIs, can help determine the extent of inflammation. Laboratory tests may reveal elevated inflammatory markers, such as sedimentation rate or CRP levels, indicating inflammatory processes.

Treatment options for sacroiliitis

The approach to treating sacroiliitis closely relates to the underlying cause of the inflammation. If an infection is present, antibiotic therapy is required, which typically leads to complete recovery. In cases of autoimmune inflammation, such as ankylosing spondylitis, the situation is more complex, as finding a long-term solution is challenging. In such cases, the use of anti-inflammatory medications may be the best option to temporarily suppress the inflammation.

During treatment, it is the responsibility of rheumatologists to recommend the most effective therapeutic options for the patient, taking into account the cause of the inflammation and the patient’s condition. The goal is to reduce pain and minimize mobility restrictions so that patients can return to their daily lives.