The anterior SIJ ligament is the weaker anterior component of the SIJ stabilisation system, reinforcing the anterior synovial joint capsule. It resists the tendency of the sacrum to slide anteriorly and inferiorly (nutation). Anterior SIJ pain is reproduced by the FABER test and anterior palpation — distinct from the posterior SIJ pain of the interosseous ligament complex.
| Origin | Anterior and inferior sacrum (lateral mass) |
|---|---|
| Insertion | Anterior ilium adjacent to the auricular surface |
| Actions | Resists anterior sacral nutation and external forces on the anterior SIJ; weaker than the posterior interosseous and posterior SI ligament complex |
|---|
Anterior SIJ injections target the anterior joint capsule under fluoroscopic guidance — contrast confirms intra-articular placement by outlining the anterior joint space. The ureter and iliac vessels lie immediately anterior to the SIJ and must be identified on cross-sectional imaging before anterior SIJ procedures.
Anterior sacroiliac ligament laxity from childbirth or trauma producing anterior pelvic pain managed with SIJ bracing and stabilisation exercises.
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