RESUMO
BACKGROUND: Osteogenesis imperfecta, also known as 'brittle bone disease', is a genetic connective tissue disease. It is characterized by bone fragility and osteopenia (low bone density). In this case, a 57-year old female presented to the University Hospital of the West Indies (UHWI), Physical Medicine and Rehabilitation Clinic with left low back pain rated 6/10 on the numeric rating scale (NRS). Clinically, the patient had sacroiliac joint mediated pain although X-rays did not show the sacroiliac joint changes. Fluoroscopy-guided left sacroiliac joint steroid injection was done. METHODS: Numeric rating scale and Oswestry Disability Index (ODI) questionnaire were used to evaluate outcome. This was completed at baseline, one week follow-up and at eight weeks post fluoroscopy-guided sacroiliac joint steroid injection. RESULTS: Numeric rating scale improved from 6/10 before the procedure to 0/10 post procedure, and ODI questionnaire score improved from a moderate disability score of 40% to a minimal disability score of 13%. Up to eight weeks, the NRS was 0/10 and ODI remained at minimal disability of 15%. CONCLUSION: Fluoroscopy-guided sacroiliac joint injection is a known diagnostic and treatment method for sacroiliac joint mediated pain. To our knowledge, this is the first case published on the use of fluoroscopy-guided sacroiliac joint steroid injection in the treatment of sacroiliac joint mediated low back pain in a patient with osteogenesis imperfecta.
RESUMO
Physiatry is a relatively new area of medicine worldwide and continues to evolve to meet the medical needs of patients. The fundamental goal of Rehabilitation Medicine is functional performance and quality of life. Lord Viscount Tedder stated, "that the greatest field of the specialty lay in the restoration of individuals to full physical fitness, for he said, "life was not merely to be alive, but to be well". One of the highest awards in the AAPMR is the Frank H Krusen Award, and one of the awardees, Henry Betts and Joel Press, the founder of the Spine and Sports Rehabilitation Center at the Rehabilitation Institute of Chicago, say, "Medicine adds years to people's life, Physiatry adds quality to those years."