This 44 yr old lady presented with sacroiliitis in the context of a recent diagnosis and treatment for breast cancer. She went on to develop a widespread joint disease similar to Ankylosing Spondylitis (www.nass.co.uk). I tried all treatments including numerous complex immune suppressing therapies without achieving control. Oral steroid and injection into joints were helpful, though the injections short lived. She developed a rare eye complication to steroid so this treatment had to be stopped. At this point there were no real options (TNF inhibitors are excluded by the prior malignancy).
Treatment. Pulsed Radiofrequency is a pain modifying treatment which is mainly used for nerve pains (sciatica/brachialgia – nerve pain in the arm) but has been used by Swiss doctors for joints. I had seen it work and also dramatically reduce inflammation in a colleague’s knee I treated, so after full discussion (there are no treatment related dangers) I treated my patient starting with the knees. At this point she had knee, hip and SIJ pain and was significantly disabled from even simple activities. The response was dramatic, her knee pain resolved fully. I subsequently treated her hips and SIJ’s all with excellent response, dramatic resolution of pain and improvement in function and she has been maintained in good health by repeat treatments over 2 years since.
Since then I have treated a variety of SIJ problems sometimes with dramatic results as seen here. Different knee problems have been more difficult to gain reproducible results.