Innominates 1/28 Flashcards
3 bones of innominate? 3 joints?
ilium, ischium, pubis
- fusion begins around age 16
- involves three major joints: SI, pubic symphysis, acetabulum
- the arrangment creates a compressive lateral force and friction to withstand the vertical load
three types of movements
1-2 are physiologoic motions
- Rotation: anterior and posterior
- Flaring: lateral and medial
#3: non-physiological motion shearing: superior/inferior
three landmarks needed to diagnose SD of the pelvis
ASIS, PSIS, pubic rami and symphysis
If Standing flexions test positive on right…. what are findings for right anteriorly rotated innominate
ASIS: inferior on right
PSIS: superior on right
Pubic tubercle: inferior on right
S/I innominate shears
- non-physiologic motions
- painful and indicative of compensated ligaments
- looks as though one innominate is posterior or inferior on the SI joint
innominate flares
- Lateral position change: ASIS medial or lateral compared to usual position
- may be though of as rotation of an innominate along a vertical axis
pubic symphysis shears
- can be superior, inferior or compressed
- generally seen with saddle injuries or other trauma
Anterior rotation of innominate
- happens with extension of hip
- standing flexion test positive
- ASIS moves inferiorly (caudad)
- PSIS moves superiorly (cephalad)
- etiology: tight quads, leg length discrepancy
- Patient may c/o hamstring tightness, spasm or even sciatica
posterior rotation
- happens with flexion of the hip \+ standing flexion test - ASIS superior (cephalad) - PSIS inferior (caudad) - superior pubes-ipsilateral - Patient may c/o: inguinal/groin pain due to rectus femoris dysfunction, medial knee pain due to sartorius dysfunction
right posteriorly rotated innominate for standing flexion test
ASIS: superior right
PSIS: inferior right
Pubic tubercle: superior right
Medial flare: Innominate Inflare
+ standing flexion test ipsilateral
- ASIS medial
- PSIS lateral
- patient c/o pelvic or sacroiliac joint pain
- tender sacroiliac ligaments and inguinal ligaments, tender point on pubic symphysis.
Lateral flare: Innominate outflare
+ standing flexion test ipsilateral
- ASIS lateral
- PSIS medial
- patient c/o pelvic or sacroiliac pain , tender sacroiliac ligaments and inguinal ligaments
superior innominate shear: “upslip”
(+) Standing Flex test-ipsilateral ASIS superior PSIS superior Pubic tubercle superior Patient may c/o pelvic pain Palpatory findings: Tissue texture changes and tenderness at ipsilateral SI and pubes
Inferior innominate shear: “downslip”
Diagnostic Criteria on Side of Restriction:
(+) Standing Flex test-ipsilateral
ASIS inferior
PSIS inferior
Pubic tubercle inferior
Patient may c/o pelvic pain.
Palpatory findings: Tissue texture changes and tenderness at ipsilateral SIJ and pubes.
superior pubic shear
(+) Standing Flex test-ipsilateral
ASIS and PSIS level
Ipsilateral pubic tubercle superior
Patient may c/o pelvic pain or pubic arch pain
Palpatory findings: Tissue texture changes and tenderness at ipsilateral pubes
- often happen with saddle injuries or mountain biking
