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Validation study of a diagnostic scoring system for sacroiliac joint-related pain

Authors Tonosu J, Oka H, Watanabe K, Abe H, Higashikawa A, Yamada K, Kuniya T, Nakajima K, Tanaka S, Matsudaira K

Received 1 March 2018

Accepted for publication 13 June 2018

Published 28 August 2018 Volume 2018:11 Pages 1659—1663


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Michael Schatman

Juichi Tonosu,1 Hiroyuki Oka,2,3 Kenichi Watanabe,1 Hiroaki Abe,1 Akiro Higashikawa,1 Koji Yamada,1 Takashi Kuniya,1 Koji Nakajima,1 Sakae Tanaka,3 Ko Matsudaira2,3

1Department of Orthopedic Surgery, Kanto Rosai Hospital, Kanagawa, Japan; 2Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan; 3Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

Background: There are no specific radiological findings for the diagnosis of sacroiliac joint-related pain. A diagnostic scoring system had been developed in 2017. The score comprised the sum of scores of six items. The score ranged from 0 to 9 points, and the cutoff was calculated as 4.
Objective: To evaluate the validity of the diagnostic scoring system for sacroiliac joint-related pain.
Patients and methods: The sacroiliac joint-related pain group (n=31) comprised patients diagnosed with sacroiliac joint-related pain based on patient history, physical findings, and responses to analgesic periarticular injection. In addition, it was confirmed that they had no other lumbar or hip joint diseases. The non-sacroiliac joint-related pain group (n=123) comprised patients with low back pain due to a reason other than sacroiliac joint-related pain. We evaluated scores for all subjects. We analyzed the differences in each item between both groups and performed receiver-operating characteristic curve analysis to evaluate the score validity.
Results: There were no significant differences in patient characteristics between groups. There were significant differences for the following four of six items: one-finger test results (P<0.0001), pain while sitting on a chair (P=0.0141), sacroiliac joint shear test results (P<0.0001), and tenderness of the posterosuperior iliac spine (P<0.0001). The cut-off value was 5 points, the area under the curve was 0.80239, sensitivity was 77.4%, and specificity was 76.4%.
Conclusion: The score demonstrated moderate validity for diagnosing sacroiliac joint-related pain.

Keywords: sacroiliac joint-related pain, diagnosis, physical findings, scoring system, validation

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