Major Perirectal Hematoma Complicating Sacroiliac Joint Injection

Abstract Background: Sacroiliac joint injection is both a way of confirming sacroiliac joint pain and a therapeutic method. Findings: A 40-year-old woman was presumptively diagnosed as having sacroiliac joint dysfunction and we performed a fluoroscopically guided sacroiliac joint injection. Many hours after the procedure, the patient developed severe buttock pain spreading to the posterior aspect of the femur on the left side. A pelvic magnetic resonance imaging revealed a 9 × 4 × 5.5 cm sized hematoma extending from the left obturator to the perirectal region. Conclusions: Because of anatomical variations, the practitioner should be alert to the risk of damaging vascular structures when performing therapeutic injections.