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Sacroiliac joint anatomy

Rebecca Peebles, Christopher E Jonas
Sacroiliac joint (SIJ) dysfunction is a common cause of low back pain in the athlete, especially in sports with repetitive, asymmetric loading. Complex anatomy and broad pain referral pattern make diagnosis difficult. Identifying three or more positive physical examination maneuvers for the SIJ improves examination sensitivity and specificity. Imaging is rarely helpful in establishing the diagnosis but is often used to rule out other pathology. Conservative management with activity modification, medication, physical therapy, manipulation and bracing is first line treatment...
September 2017: Current Sports Medicine Reports
Marcus Cox, Garrett Ng, Faizullah Mashriqi, Joe Iwanaga, Fernando Alonso, Kevin Tubbs, Marios Loukas, Rod J Oskouian, R Shane Tubbs
OBJECTIVE: Sacroiliac joint pain can be disabling and recalcitrant to medical therapy. The innervation of this joint is poorly understood, especially its anterior aspect. Therefore, the present cadaveric study was performed to better elucidate this anatomy. METHODS: Twenty-four cadaveric sides underwent dissection of the anterior sacroiliac joint, with special attention given to any branches from regional nerves to this joint. RESULTS: No femoral, obturator, or lumbosacral trunk branches destined to the anterior sacroiliac joint were identified in the 24 sides...
November 2017: World Neurosurgery
Stacey Bennis, Sarah Hwang
The history and physical examination are important keys to diagnosis and treatment of patients with chronic pelvic pain. The comprehensive history should include questioning regarding patient's pain complaint and a thorough history and review of any body system that may be involved, including neuromusculoskeletal, obstetric, gynecologic, gastrointestinal, urologic, dermatologic, infectious, oncologic, and psychiatric. The physical examination should also follow a focused systems-based approach and includes examination of gastrointestinal, dermatologic, neurologic, and musculoskeletal (including lumbosacral spine, sacroiliac joints, pelvis, and hips) systems, and the pelvic floor (internal and external examination, including neuromuscular anatomy)...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
Chian-Her Lee, Ching-Chi Hsu, Po-Yuang Huang
The pelvis is one of the most stressed areas of the human musculoskeletal system due to the transfer of truncal loads to the lower extremities. Sacroiliac joint injury may lead to abnormal joint mechanics and an unstable pelvis. Various fixation techniques have been evaluated and discussed. However, it may be difficult to investigate each technique due to variations in bone quality, bone anatomy, fracture pattern, and fixation location. Additionally, the finite element method is one useful technology that avoids these variations...
August 1, 2017: Computers in Biology and Medicine
K Venugopal Menon, S S Suresh, Sivaprasad Kalyanasundaram, Jacob Varughese
INTRODUCTION: Day's classification and treatment guidelines are considered the gold standard in crescent fractures of the pelvis. The objective of this study was to retrospectively evaluate 10 surgically treated crescent fractures of the pelvis in the context of Day's recommendations. METHODS: This is a retrospective cohort study. Ten consecutive cases of crescent fractures that were treated surgically at a level 1 trauma center formed the cohort. Six were operated anteriorly, three posteriorly and one percutaneously...
May 23, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Matthew D Burgess, Mickaila J Johnston, Eugene D Silverman
A 19-year-old male military recruit presented with 3 weeks of persistent left hip and groin pain after abnormally twisting his hip during a hike. Initial radiographs were interpreted as negative. He subsequently underwent a bone scan which revealed linear left sacral uptake along or paralleling the sacroiliac joint. Differential diagnostic considerations included unilateral sacroiliitis and sacral fracture. SPECT/CT was performed which confirmed left sacral fatigue stress fracture. Transitional lumbosacral anatomy was evident on radiographs with pseudoarticulation of the transitional left S1 transverse process with the sacrum...
June 2017: Clinical Nuclear Medicine
Christopher J Kleck, James M Perry, Evalina L Burger, Christopher M J Cain, Kenneth Milligan, Vikas V Patel
During the past 10 years, the sacroiliac (SI) joint has evolved from being barely recognized as a source of pain, to being a joint treated only nonsurgically or with great surgical morbidity, to currently being a joint treated with minimally invasive techniques that are personalized to the individual patient. The complex 3-dimensional anatomy of the SI joint and lack of parallel to traditional imaging planes requires a thorough understanding of the structures within and around the SI joint that may be at risk of injury...
March 2016: Orthopedics
Carmine Zoccali, Jesse Skoch, Apar S Patel, Christina M Walter, Mauricio J Avila, Nikolay L Martirosyan, Silvio Demitri, Ali A Baaj
OBJECTIVE: The anatomic area delineated medially by the lateral part of the L4-L5 vertebral bodies, distally by the anterior-superior surface of the sacral wing, and laterally by an imaginary line joining the base of the L4 transverse process to the proximal part of the sacroiliac joint, is of particular interest to spine surgeons. We are referring to this area as the lumbo-sacro-iliac triangle (LSIT). Knowledge of LSIT anatomy is necessary during approaches for L5 vertebral and sacral fractures, sacral and iliac tumors, and extraforaminal decompression of the L5 nerve roots...
April 2016: World Neurosurgery
Xinxin Ma, Shiyao Shang, Bing Xie, Xiuli Sun, Xin Yang, Jing Wu, Nan Hong, Jianliu Wang
OBJECTIVE: To evaluate morphological structure of uterosacral ligament (USL) and cardinal ligament (CL) in patients with severe pelvic organ prolapse (POP) by MRI technology, and to analysis and discuss its clinical significance. METHODS: From November 2013 to February 2014 in Peking University People's Hospital, 26 elderly patients with III-IV degree of POP were selected as the POP group and 18 healthy elderly volunteers were selected as the control group during the same period...
September 2015: Zhonghua Fu Chan Ke za Zhi
Sumit H Rana, Payam Farjoodi, Sean Haloman, Pascual Dutton, Arvin Hariri, Samuel R Ward, Steven R Garfin, Douglas G Chang
BACKGROUND: Sacroiliac joint (SI) pain is increasingly being recognized as a source of low back pain. Injections and percutaneous type procedures are performed to treat symptomatic joints. However, there are limited studies available assessing the anatomy of the SI joint in vivo among patients with pain. OBJECTIVES: The purpose of this study was to provide more precise information on the dimensions and orientation of the SI joint using a new technique for the radiographic evaluation of this joint...
November 2015: Pain Physician
Ha Son Nguyen, Narayan Yoganandan, Dennis Maiman
BACKGROUND: Following lumbar fusion, sacroiliac (SI) joint pain has been regarded as a form of adjacent segment disease. Prior studies suggest increased stress to the SI joint and pelvis with lumbar fusion. Limited studies have evaluated the relationship between the extent of lumbar fusion and its potential influence on lumbopelvic parameters, which may provide the insights to persistent back pain. METHODS: Three hundred fifty-five patients underwent lumbar fusions at our institution between fall 2010 and winter 2012; 80 patients met criteria for the study...
2015: Surgical Neurology International
Jonathan P Eskander, Juan G Ripoll, Frank Calixto, Burton D Beakley, Jeffrey T Baker, Patrick J Healy, O H Gunduz, Lizheng Shi, Jamie A Clodfelter, Jinan Liu, Alan D Kaye, Sanjay Sharma
BACKGROUND: Pain emanating from the sacroiliac (SI) joint can have variable radiation patterns. Single physical examination tests for SI joint pain are inconsistent with multiple tests increasing both sensitivity and specificity. OBJECTIVE: To evaluate the use of fluoroscopy in the diagnosis of SI joint pain. STUDY DESIGN: Prospective double blind comparison study. SETTING: Pain clinic and radiology setting in urban Veterans Administration (VA) in New Orleans, Louisiana...
September 2015: Pain Physician
Justin A Iorio, Andre M Jakoi, Saqib Rehman
Percutaneous sacroiliac (SI) screw fixation is indicated for unstable posterior pelvic ring injuries, sacral fractures, and SI joint dislocations. This article provides a review of indications and contraindications, preoperative planning, imaging techniques and relevant anatomy, surgical technique, complications and their management, and outcomes after SI screw insertion.
October 2015: Orthopedic Clinics of North America
Ulrich Weber, Walter P Maksymowych, Stanley M Chan, Kaspar Rufibach, Susanne J Pedersen, Zheng Zhao, Veronika Zubler, Mikkel Østergaard, Robert G W Lambert
INTRODUCTION: Inflammation of the sacroiliac joints (SIJ) is a fundamental clinical feature of axial spondyloarthritis (SpA). The anatomy of the irregularly shaped SIJ is complex with an antero-inferior cartilaginous compartment containing central hyaline and peripheral fibrocartilage, and a dorso-superior ligamentous compartment. Several scoring modules to systematically assess SIJ magnetic resonance imaging (MRI) in SpA have been developed. Nearly all of them are based on the cartilaginous joint compartment alone...
2015: Arthritis Research & Therapy
Hong-min Cai, Chuan-de Cheng, Xue-jian Wu, Wu-chao Wang, Jin-cheng Tang, Shou-ya Chang, Wei-feng Duan, Wu-yin Li
OBJECTIVES: To research radiographic anatomy of the main structure of the pelvic Teepee view, including its azimuth direction and view anatomy structure. METHODS: From June 2013 to June 2014 adult pelvic CT examination results were filtered, excluding skeletal deformities and pelvic osseous destruction caused by tumors, trauma, etc. The data of 2.0 mm contiguous CT scan of 9 adults' intact pelves was,selected and input into Mimics 10.01 involving 7 males and 2 females with an average age of (41...
May 2015: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Carmine Zoccali, Jesse Skoch, Apar Patel, Christina M Walter, Philip Maykowski, Ali A Baaj
PURPOSE: Pelvic and sacral surgeries are considered technically difficult due to the complex multidimensional anatomy and the presence of significant neurovascular structures. Knowledge of the key neurovascular anatomy is essential for safe and effective execution of partial and complete sacral resections. The goal of this anatomic, cadaveric study is to describe the pertinent neurovascular anatomy during these procedures. METHODS: Three embalmed human cadaveric specimens were used...
May 2015: European Spine Journal
Kanna Nakamura, Sonoko Matsumoto, Tatsuya Enomoto, Atsuko Hara, Hiromasa Mitsuhata
BACKGROUND: The sacroiliac joint (SIJ) is recognized as a potential source for low back pain especially in elderly people. Previous studies indicated that in patients with SIJ pain, posterior sacroiliac ligament injections are more effective than intra articular injections. The aim of this study was to assess usefulness of ultrasound sonography (US) in performing posterior sacroiliac ligament injection. METHODS: We examined SIJ and ligaments, and injected local anesthetics using ultrasonography...
December 2014: Masui. the Japanese Journal of Anesthesiology
Christoph J Laux, Georg Osterhoff, Clément M L Werner
The sacroiliac joints are causative for 13-30% of cases with low back pain and are still disregarded in the differential diagnosis. This is mainly due to its complex anatomy and the variety of pain patterns originating from the SI joints. The broad etiology of low back pain often misleads the physician into inadequate treatments. This article reviews the clinical presentation of patients suffering from a sacroiliac arthropathy and points out therapeutic strategies. It also provides a helpful diagnostic tool in daily routine...
January 2, 2015: Praxis
Ömer Faruk Bilgen, Necmettin Salar, Muhammet Sadık Bilgen, Müren Mutlu, Gökhan Kürşat Kara, Enis Gürsel
Classification of hip pathology in developmental dysplasia of the hip (DDH) helps in appropriate placement of implants during total hip arthroplasty. We examined preoperative unilateral and bilateral pelvic radiographs of 57 patients (114 hips) undergoing total hip arthroplasty because of DDH. Both sides of the pelvis were visually separated into 3 areas for comparison. When area ratios of hips with Crowe types II, III, and IV DDH were compared with ratios for healthy hips, values in hips with DDH were significantly low for the iliac wings, significantly high for the acetabular regions, and significantly low for the ischial area...
May 2015: Journal of Arthroplasty
Jianglong Huang, Zongheng Zheng, Hongbo Wei, Jiafeng Fang, Shi Zhang, Yuqing Chen
OBJECTIVE: To further understand the anatomical basis of pelvic autonomic nerve preservation. METHODS: Autopsy of five adult male donated cadavers was performed. Meanwhile, ten videos of laparoscopic total mesorectal excision for male mid-low rectal cancer admitted from January to June 2012 were observed and studied. Anatomical features of pelvic autonomic nerve were compared between autopsy and laparoscopic appearance. RESULTS: Autopsy observations indicated that:the abdominal aortic plexus was situated upon the sides and front of the aorta, between the origins of the superior and inferior mesenteric arteries...
July 2014: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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