The sacroiliac (SI) joint is a common cause of lower back and buttock pain, but it is often misdiagnosed. A precise diagnosis is key to effective treatment. Clinical exams help identify SI joint pain. One highly accurate test is the Fortin Finger Test, where patients pinpoint pain directly over the SI joint.

Provocative maneuvers like the FABER and Gaenslen’s tests can reproduce pain, further confirming the diagnosis. Imaging is essential to rule out other causes.

A hip X-ray ensures the pain isn’t coming from hip arthritis, while a lumbar MRI checks for disc or nerve issues in the spine. A sacral CT scan can provide detailed views of the SI joint to detect arthritis or other structural problems.

The most reliable way to diagnose SI joint pain is a fluoroscopy-guided SI joint injection. Research shows that if an anesthetic injection relieves pain, it confirms the SI joint as the source with high accuracy.

Treatment starts with physical therapy, bracing, and anti-inflammatory medications. If pain continues, SI joint injections with steroids or regenerative treatments like platelet rich plasma may provide relief.

For chronic cases, advanced options like minimally invasive SI joint fusion or spinal cord stimulation (SCS) may help. Studies show that SCS can effectively manage SI joint pain by altering pain signals before they reach the brain.

If you have ongoing lower back or buttock pain, proper imaging and precise diagnostic methods can lead to targeted treatment and lasting relief.