Interobserver reliability on landmark-guided sacroiliac joint injection among 5th year residency in Orthopedic and Traumatology Department Faculty of Medicine Brawijaya University Malang, Indonesia

Abstract

Background: The most common misdiagnosed low backpain is result from the sacroiliac joint. There are a lot of methods we can use to treat it such as steroid injection. This method can be done by using landmark-guided technique or image-guided. Unfortunately, not all hospital in this country has the same facility to do image-guided technique using fluoroscopy to do the injection. Therefore, landmark-guided technique still could be used for the treatment of choice.

Methods: In this research, authors did injection on sacroiliac joint of 7 preserved cadavers, on both sacroiliac joint, injection were done by 2 operators, which both are 5th- year residents of Orthopedic and Traumatology Department using 2 coloring markers, therefore each of operator got 14 injection spots. Operator  1 uses methyl red, and operator 2 uses methylene blue. The success of the injection evaluated visually. If operator 1 achieved the injection, the sacroiliac joint would be bright red coloured. If operator 2 achieved the injection, the sacroiliac joint would be blue coloured. If both operator achieved the injection on the same joint, the mixture of both will be dark green coloured.

Results: The result shown the success of both operator in doing injection for the sacroiliac joint is 9 joints (32.14%). There were 5  joints (17.86%) done by operator 1, and  4 joints (14.28%) done by operator 2. Operator 1 failed on 9 (32.14%) joints and operator 2 failed on 10 (35.72%) . The data was statistically analysed using Fisher Exact Test, result in p value 0.500 (p >0.05).

Conclusions: In conclusion there is no significantly different the success of the injection between operator 1 and 2. The failure of the injection on sacroiliac joint could be affected by many factors such as injection technique, and anatomy variations of the sample.