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Brown: Atlas of Regional Anesthesia, 3rd ed., Copyright © 2006 Saunders, An Imprint of Elsevier
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PEARLS

Sacroiliac block appears to be an underutilized diagnostic and therapeutic pain control technique. One of the first requirements when using this block effectively is to think about the possibility that sacroiliac joint pain is a potential source of the patient’s low back pain. Additionally, a logical, prospectively planned sequence of fluoroscopically guided sacroiliac block injections should be developed. It is clear that radiographic guidance is not needed in all cases, but a certain percentage of cases require the validation provided by this technique. It is helpful if this question is considered before a decision is needed in a specific case. Also, an underappreciated symptom of sacroiliac joint pain is referral of the pain to the ipsilateral groin. Relief of groin pain after sacroiliac block seems to be linked to the sacroiliac joint as a real source of low back pain. Finally, it is helpful always to warn patients before performing a sacroiliac block that a small percentage of patients do develop a temporarily numb ipsilateral leg. Advance information about this phenomenon seems to smooth clinical care even if the procedure results in a lower extremity block.

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