Other Modalities, Other Reasons
B. G. Brogdon, Hermann Vogel, John D. McDowell in A Radiologic Atlas of Abuse, Torture, Terrorism, and Inflicted Trauma, 2003
FIGURE 27.1 Identification by comparison of antemortem and postmortem CT. The antemortem study is on the viewer’s left in every instance. (A) Posterolateral disc herniation at L5-S1. (B) Small Schmorl’s node in the inferior end-plate of L4. (C) Peculiar thickening of the right transverse process of L4. (D) Shows identical lucencies in the left ilium at the sacroiliac joint. (Original images courtesy of the authors. Copyright ASTM International. Reprinted with permission.) FIGURE 27.2(A) Topogram, or scout film, of an antemortem CT study of an elderly female with hyperostosis interna frontalis is easily matched with (B) a routine skull film showing the same condition and an identical configuration of the sella and other anatomy of the skull.
Skeleton of pelvis and lower limb, popliteal fossa, foot ligaments
Ian Parkin, Bari Logan, Mark McCarthy in Core Anatomy - Illustrated, 2007
The pelvic girdle is formed by the hip bones (1) articulating with each other and with the sacrum (2). The sacro-iliac joints (3) are synovial with a fibrous capsule supported by strong anterior, posterior and intra-articular ligaments. Movement is limited. The ligaments relax a little during pregnancy, allowing a wider pelvis for delivery, but possibly causing back pain. (also caused by arthritis of the joints). The body weight tends to tilt the upper sacrum down and forward, but the lower sacrum is prevented from consequently swivelling up and backward by the sacrotuberous (4) and sacrospinous (5) ligaments. The former passes to the ischial tuberosity from the posterior aspects of the ilium, sacrum and coccyx, lying external to the sacrospinous ligament that passes to the ischial spine from a smaller, sacral origin. The greater sciatic foramen (6) transmits nerves and vessels from the pelvis to the buttock. The lesser sciatic foramen (7) is inferior to the sacrospinous ligament, therefore inferior to the pelvic floor. Nerves and vessels passing through it enter the perineum.
BIOMECHANICS OF SACROILIAC JOINT
Robert Maigne, Walter L. Nieves in Diagnosis and Treatment of Pain of Vertebral Origin, 2006
Since Hippocrates, who was the first to note it, it has been universally accepted that the sacroiliac joint plays an important role in childbirth. In contradistinction to prior authors (Vésale included), Ambroise Paré confirmed that a certain mobility also existed outside the state of pregnancy and also in men. The works of Delmas and Weisl uncovered facts that led to an understanding of the anatomy and physiology of this articulation that differed greatly from the classic concept of Farabeuf.
High frequency of lumbar fusion in patients denied surgical treatment of the sacroiliac joint
Published in British Journal of Neurosurgery, 2019
Vicente Vanaclocha-Vanaclocha, Juan Manuel Herrera, Nieves Sáiz-Sapena, Marlon Rivera-Paz, Francisco Verdú-López
Purpose: Effective treatment of medical conditions relies on proper diagnosis. Clinical trials show the safety and effectiveness of sacroiliac joint (SIJ) fusion in patients with chronic SI joint dysfunction. To what extent is the condition under recognised? Objective: To determine whether under recognition of SIJ pain affects healthcare trajectories in Spanish patients with low back pain. Methods: Retrospective study of characteristics and consequences of 189 patients with persistent SIJ pain seen in an outpatient neurosurgery clinic. Results: Patients with SIJ pain who were denied surgical treatment had a longer pain duration, higher likelihood of prior lumbar fusion, and a high rate (63%) of lumbar fusion within 2 years prior to SIJ pain diagnosis, which, in most cases, provided little benefit. Conclusions: Lack of knowledge of the role of the SIJ in chronic low back pain probably results in diagnostic confusion and may lead to misdirected treatment.
Sacroiliac joint dysfunction as a reason for the development of acetabular retroversion: a new theory
Published in Physiotherapy Theory and Practice, 2014
Acetabular retroversion has been recently implicated as an important factor in the development of femoral acetabular impingement and hip osteoarthritis. The proper function of the hip joint requires that the anatomic features of the acetabulum and femoral head complement one another. In acetabular retroversion, the alignment of the acetabulum is altered where it opens in a posterolaterally instead of anterior direction. Changes in acetabular orientation can occur with alterations in pelvic tilt (anterior/posterior), and pelvic rotation (left/right). An overlooked problem that alters pelvic tilt and rotation, often seen by physical therapists, is sacroiliac joint dysfunction. A unique feature that develops in patients with sacroiliac joint dysfunction (SIJD) is asymmetry between the left and right innominate bones that can alter pelvic tilt and rotation. This article puts forth a theory suggesting that acetabular retroversion may be produced by sacroiliac joint dysfunction.
Physical therapy management of osteitis pubis in a 10-year-old cricket fast bowler
Published in Physiotherapy Theory and Practice, 2013
This case report describes a 10-year-old boy who presented with radiating pain (Visual Analog Scale score of 7.2 cm) down his left groin and was eventually diagnosed to have osteitis pubis. History revealed that he was exceeding the workload guidelines of bowling for a fast bowler. Examination findings were left sacro-iliac joint dysfunction, reduced left internal rotation of the hip, tightness of bilateral hip flexors and poor motor control of the lumbo-pelvic muscles. Physical therapy was aimed at correcting the sacro-iliac joint dysfunction, increasing the hip range of motion and muscle length along with exercises aimed at improving the lumbopelvic stability. The patient had complete resolution of pain by the ninth week and returned to fast bowling without any discomfort.