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Exercise-related stress reaction of the sacroiliac joint

An unusual cause of low back pain in athletes

Department of Laboratory Medicine, Wesley Medical Center

Mary A. Lynch, MD

Mid-America Institute of Sports Medicine, Wichita, Kansas

Charles E. Henning, MD

Mid-America Institute of Sports Medicine, Wichita, Kansas

Low back pain, secondary to a variety of musculoskel etal injuries, is common in individuals engaged in ath letics. Sports-related stress reactions of the pars inter articularis are not uncommon. Stress reactions of the sacroiliac joint, on the other hand, are considered very rare. The limitations of plain radiographs and the ability of bone scintigraphy to detect stress lesions in athletes is well documented. In this paper we describe four young athletes with stress reactions of the sacroiliac region. We consider these to be uncommon but not rare, and probably self-limiting. Accurate diagnosis is important, however, to exclude more important causes of low back pain that require therapy. This type of injury also results in abnormal stresses to the lower extremi ties which can result in an independent and more serious injury. All sacroiliac stress reactions were un suspected and were diagnosed only by bone scin tigraphy after plain radiographs were noncontributory.

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