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European Spine Journal

, Volume 22, Issue 7, pp 1657–1664 | Cite as

Sciatica-like symptoms and the sacroiliac joint: clinical features and differential diagnosis

  • L. H. VisserEmail author
  • P. G. N. Nijssen
  • C. C. Tijssen
  • J. J. van Middendorp
  • J. Schieving
Original Article

Abstract

Purpose

To compare the clinical features of patients with sacroiliac joint (SIJ)-related sciatica-like symptoms to those with sciatica from nerve root compression and to investigate the necessity to perform radiological imaging in patients with sciatica-like symptoms derived from the SIJ.

Methods

Patients with pain radiating below the buttocks with a duration of 4 weeks to 1 year were included. After physical and radiological examinations, a diagnosis of SI joint-related pain, pain due to disk herniation, or a combination of these two causes was made.

Results

Patients with SIJ-related leg pain (n = 77/186) were significantly more often female, had shorter statue, a shorter duration of symptoms, and had more often pain radiating to the groin and a history of a fall on the buttocks. Muscle weakness, corkscrew phenomenon, finger-floor distance ≥25 cm, lumbar scoliosis, positive Bragard or Kemp sign, and positive leg raising test were more often present when radiologic nerve root compression was present. Although these investigations may help, MRI of the spine is necessary to discriminate between the groups.

Conclusions

Sciatica-like symptoms derived from the SIJ can clinically mimic a radiculopathy. We suggest to perform a thorough physical examination of the spine, SI joints, and hips with additional radiological tests to exclude other causes.

Keywords

Sacroiliac joint Leg pain Sciatica Lumbar disk Differential diagnosis 

Notes

Conflict of interest

There is no actual or potential conflict of interest in relation to this article.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • L. H. Visser
    • 1
    Email author
  • P. G. N. Nijssen
    • 1
  • C. C. Tijssen
    • 1
  • J. J. van Middendorp
    • 2
  • J. Schieving
    • 1
  1. 1.Department of NeurologySt. Elisabeth HospitalTilburgThe Netherlands
  2. 2.Department of OrthopaedicsNijmegenThe Netherlands

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