836 - Radiofrequency Ablation of the Sacroiliac Joint in Patient with Heterotopic Ossification of the Left Hip: A Non-Surgical Approach to Pain Management

Thursday, February 22, 2024

5:00 PM – 6:30 PM EDT

Presenting Author(s)

AK

Alexis D. Kotsovolos, BSc

Undergraduate Student
University of South Florida
Tampa, Florida, United States

Co-Author(s)

AJ

Ankur Jain, BS

4th Year Medical Student
Rehabilitation and Electrodiagnostics
Tampa, Florida, United States
NJ

Navdeep S. Jassal, MD

Asst clinical Professor
university of central Florida
Lakeland, Florida, United States

Case Diagnosis: A 52-year-old male presented with chronic hip and low back pain, which persisted despite numerous conservative treatments. Upon examination, sacroiliac joint pain was evident, mimicking hip pain, and was attributed to Heterotopic Ossification (HO). Imaging revealed hip joint osteoarthritis and lumbar surgical changes. Due to the patient's preference for non-surgical interventions, Radiofrequency Ablation (RFA) of the sacroiliac joint was considered as a pain management option.

Case Description: The patient's debilitating pain, characterized as deep, stabbing, and exacerbated by daily activities, led to unsuccessful conservative treatments, including physical therapy, medications, and injections. Two diagnostic medial branch blocks resulted in significant pain relief, prompting bilateral RFA of the Sacroiliac joint under fluoroscopic guidance. This minimally invasive procedure utilized local anesthesia (Marcaine) and Dexamethasone. Post-procedure, the patient reported a reduction in pain intensity, from 9/10 to 4/10, and improved functionality. Annual RFA procedures sustained these benefits for five years, averting surgical HO resection.

Discussions: Heterotopic Ossification (HO) poses unique challenges in pain management, especially when it masquerades as hip pain originating from the Sacroiliac joint. This case highlights the successful use of Radiofrequency Ablation (RFA) as a non-surgical approach for HO-related chronic pain. RFA, guided by fluoroscopy, offered targeted relief and precise probe placement, avoiding surgical complications. Timely consideration of RFA for HO-related pain is crucial, potentially replacing the need for surgical interventions in patients with hip pain and similar conditions affecting various joints.

Conclusions: In conclusion, this case highlights the effectiveness of RFA as a safe and efficient non-surgical option for managing chronic Sacroiliac joint pain in patients with Heterotopic Ossification. It underscores the significance of proper diagnosis and emphasizes that RFA should be considered as an earlier treatment regimen for other joint regions, such as the cervical, shoulder, lumbar, hip, and knee, to optimize pain and improve functional mobility.