How is sacroiliac (SI) pain diagnosed and treated?

The diagnosis is based on history, tenderness over the SI joint, and exclusion of other diagnoses. One needs to evaluate rheumatological disorders, most commonly ankylosing spondylitis. There are no good physical exam tests, laboratory tests, and or radiographic tests for SI diagnosis. However, if there is evidence noted on plain film x-rays, bone scans and/or MRI, it is felt to be a very specific diagnosis. Treatment is typically with anti- inflammatory medication, physical therapy, steroid injections either into the SI ligaments or the SI joint itself, chiropractic adjustments, and rarely fusion of the SI joint. Some will do radiofrequency procedures attempting to deinnervate the SI joint.