BACKGROUND: Sacro-iliac joint (SIJ) pain is an often-misdiagnosed cause (up to 30% cases) of atypical low back pain (LBP) that might be treated with a wide range of conservative interventions. However, Platelet-Rich-Plasma (PRP) ultrasound-guided injections at SIJ level in subjects with mitochondrial disorders have not yet been investigated. CASE PRESENTATION: A 52-year-old Caucasian male with fluoroquinolone-related mitochondrial dysfunction referred to a Physical Medicine and Rehabilitation Outpatient, complaining of severe SIJ pain (Numeric Pain Related Scale, NPRS=8). We performed two bilateral PRP ultrasound-guided injections at the sacro-iliac level. PRP is a simple, efficient, and minimally invasive approach. After the first PRP injection, there was a considerable reduction of pain (NPRS=8 vs 5). The second PRP infiltration was performed after 2 weeks and in both cases no adverse events. At the 6-month follow-up evaluation, the patient showed good physical recovery, with the absence of pain (NPRS=0). CONCLUSION: To the best of our knowledge, this is the first report in the literature assessing the safety and effectiveness of PRP ultrasound-guided injections for SIJ pain in a patient affected by mitochondrial disorders. Thus, this case report might have relevant clinical implications in the treatment of SIJ pain in patients affected by this rare pathological condition, albeit further observational studies are warranted to confirm these findings.

Antalgic Mini invasive and Rehab Outpatients Unit Department of Medicine and Science of Aging University G d'Annunzio Chieti Pescara Italy

Department of Rehabilitation Medicine 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Physical and Rehabilitative Medicine Department of Health Sciences University of Eastern Piedmont A Avogadro Novara Italy

Physical and Rehabilitative Medicine Department of Medical and Surgical Sciences University of Catanzaro Magna Graecia Catanzaro Italy

Physical Medicine and Rehabilitation Unit Department of Neurosciences ASST Carlo Poma Mantova Italy

Transfusion Medicine and Immunohematology Unit University Hospital Maggiore della Carità Novara Italy

Translational Medicine Dipartimento Attività Integrate Ricerca e Innovazione Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo Alessandria Italy

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