Diagnostic criteria of sacroiliac joint dysfunction in children and adolescents with pain in the lumbosacral region of the spine

Abstract

BACKGROUND: Back pain is addressed by physicians of many specialties. In many ways, it is associated with a decreased volume of dynamic motor activity and increased static loading. In patients with an active lifestyle, back pain often develops when the technique of physical exercises or habitual movements are violated, often leading to secondary osteoarticular disorders. One of the most common causes of non-specific back pain is sacroiliac joint dysfunction. The ambiguity of information on the types, severity and significance of sacroiliac joint dysfunction has urged us to systematize the existing data so as to create an optimal diagnostic algorithm for the discussed pathology.
 AIM: To develop a system for examining patients with back pain so as to make the diagnostics of sacroiliac joint dysfunction more accurate.
 MATERIALS AND METHODS: 54 patients aged 718 (mean age 14.63.32) with pain in the lumbosacral spine were included in the study. All of them had the confirmed dysfunction of sacroiliac joint; specific causes of pain were excluded. The patients were divided into 2 groups, comparable in the number, sex, and age. The patients underwent a clinical neurological and neuroorthopedic examination with additional functional muscle testing, including the assessment of their overall and local muscle strength, elasticity, coordination, biomechanical characteristics, and muscle control. The state of the respiratory muscles (tonus, type of pain, irradiation, elasticity of ribs, etc.) was evaluated during the manual testing, too. A particular attention was paid to testing using an unstable support (redcord/exarta, fitballs and balancing pads). For the better objectivity of the findings, AlterG, TecnoBody, Oxiterra test devices were used additionally.
 RESULTS: The anamnestic predictors for the development of sacroiliac joint dysfunction were revealed. The specifics of the postural and biomechanical disorders in children and adolescents with unspecific back pain were analyzed. Cervical disorders were found which promoted secondary osteoarticular dysfunction, including the sacroiliac joint block. A diagnostic algorithm has been developed to identify the underlying cause of back pain in the case of sacroiliac joint dysfunction.
 CONCLUSION: The proposed diagnostic algorithm simplifies and systematizes the treatment of patients with sacroiliac joint dysfunction and complaints of back pain. The effectiveness of rehabilitation is improved due to a possibility to precisely select the rehabilitation technique.