| A 50-year-old female patient presents with an 8-month history of lower right-sided buttock pain. She has tenderness to palpation directly over the posterior superior iliac spine. She has positive Gaenselen, compression, femoral shear, and FABER (flexion abduction external rotation) tests, and negative distraction and sacral thrust tests. Which of the following is the best next step for this patient? |
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- Minimally invasive sacroiliac joint fusion A diagnosis should be confirmed followed by management with nonoperative treatment modalities before surgery is considered.
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- Radiofrequency ablation Studies demonstrating success with radiofrequency ablation confirmed diagnosis with intra-articular injection prior to ablation.
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- Intra-articular sacroiliac joint corticosteroid injection A sacroiliac joint corticosteroid injection is the best next step. It can be both diagnostic and therapeutic, and nonoperative options should be explored prior to considering surgery.
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- Open sacroiliac joint fusion A diagnosis should be confirmed followed by management with nonoperative treatment modalities before surgery is considered.
