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Anatomy of the Pelvis
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
In the standing posture, the plane of the brim is oblique, lying at 60° with the horizontal plane, while the plane of the outlet/inferior aperture is about 15°. Since the pelvis tilts forwards, the posterior parts of both planes are above the anterior. In a sitting position, the body weight is borne by the inferiomedial aspect of ischial tuberosities.
Anatomy Trains Structural Integration
Published in David Lesondak, Angeli Maun Akey, Fascia, Function, and Medical Applications, 2020
This session aims to further align the structural support to the back of the body, calcaneus, ischial tuberosities, sacrum, and mid-dorsal hinge—freeing the pelvis from behind and allowing the sacrum more ease in movement. It also focuses on any paraspinals, deeper spinal bends and/or rotations and also the often-strained deep lateral rotators.
Treatment of Pressure Sores
Published in J G Webster, Prevention of Pressure Sores, 2019
Guttmann (1976) classified pressure sores by the degree of tissue damage. Transient was a disturbance of the circulation in the tissue marked by reversible erythema with some edema. Definite skin damage was divided into three cases. The mildest case was marked by the presence of erythema and congestion with discoloration and induration of the skin. Pressure sores that included superficial skin death, exposed cutis vena, and possible blister development were included in the second case of definite skin damage. The third and most severe case was marked by necrosis and ulcer formation with possible pigmentation of the border zones of the sore. Deep penetrating necrosis included sores that involved the subcutaneous tissues (fascia, muscle, and bone) and may have formed into large, grotesque shapes. Sinus sores communicating with bursae included sores that enclosed a sac or envelope lined with synovia and containing fluid. Closed ischial bursa was a specific form of pressure sores that were associated with the later stages of paraplegia. They were caused by acute trauma (e.g. bumping buttocks) and were marked by swelling with bloodstained fluid and/or a cavity. The most severe (and rarest) degree of pressure sore was cancerous degeneration.
Long-term radial extracorporeal shock wave therapy for neurogenic heterotopic ossification after spinal cord injury: A case report
Published in The Journal of Spinal Cord Medicine, 2022
Yun Li, Yulan Zhu, Zhen Xie, Congyu Jiang, Fang Li
All treatments, including routine physical therapies and RSWT, as well as follow-up, were conducted from May 2018 to May 2019, at the Department of Rehabilitation Medicine, Huashan Hospital of Fudan University, Shanghai. The assessment intervals during the treatment were 1.5, 3, 7 and 11 months after the first intervention. The outcome measurements showed significant improvement throughout the therapeutic period. Ultrasound examination suggested that the size of hyperechoic foci had shown a gradual decrease from 45 mm*25 mm to 18 mm*16 mm (Figure 1). CT scans also revealed the reduction of ossification mass at the ilium, ischium, femur cross-section, respectively. Three-dimensional reconstruction CT further proved that the volume of ossification mass decreased throughout the year after first RSWT intervention (Figure 2). The passive ROM of the hip joint was severely limited at the very early phase of NHO, which was gradually increased during the course of RSWT. The pain was mitigated as suggested by the reduction of VAS score from 8 to 1 after 1.5 months of the treatment which was maintained for another five months. The patient complained of no pain in the last session of the treatment. The sALP level declined from 184 IU/L to 126 IU/L after the first session of the treatment, and kept stable around five months, then further declined to 86 IU/L in the end (Table 1).
The intra- and inter-rater reliability of the Goldsmith indices of body symmetry in non-ambulant adults with cerebral palsy
Published in Disability and Rehabilitation, 2021
Carlee Holmes, Emma Fredrickson, Kim Brock, Prue Morgan
A further limitation was the inability to accurately capture pelvic obliquity with the tool, an abnormal tilt of the pelvic girdle that may occur in all three movement planes. It is associated with progressive scoliosis and hip dislocation, pain and necrosis of ischial tuberosities [24]. Pelvic obliquity is part of a triad, together with scoliosis and windswept hips, which is extremely difficult to treat once established [4]. The Goldsmith Indices of Body Symmetry captures elements of pelvic asymmetry through the pelvic bridge apparatus, specifically rotation in the frontal plane, however the contribution of pelvic obliquity is unable to be teased out from that of hip contracture. The potential to specifically measure pelvic obliquity using the Goldsmith Indices of Body Symmetry pelvic bridge requires additional investigation.
Usefulness of magnetic resonance imaging to diagnose greater trochanteric-ischial impingement
Published in Baylor University Medical Center Proceedings, 2021
Munif Hatem, Kathryn E. Canavan, RobRoy L. Martin, Jonathan Dawkins, Hal David Martin
Extra-articular impingement between the femur and ischium is a cause of hip pain and is reported both in native hips and following hip surgery.1–7 Impingement between the lesser trochanter and the ischium occurs at terminal hip extension,1–3 while greater trochanteric-ischial impingement (GTI) occurs with the hip positioned in mid-flexion, abduction, and external rotation (FABER).5,8 This position is similar to that observed during squatting, sitting with legs crossed, or during intercourse. Sciatica may also be provoked by the compression of the sciatic nerve between the GT and the ischium.9 The purpose of this study was to assess the diagnostic parameters for GTI in magnetic resonance imaging (MRI). A secondary purpose was to identify threshold values for abnormal greater trochanteric-ischial and greater trochanteric-hamstring distances.