Lecture 2: Innominates

Question 1

Why are innominates clinically relevant?

Answer 1

• functional problems = back pain

- influences functioning and regulation of lymphatics, GI and GU systems

Question 2

What bones make up the innominates?

What joints make up the innominates?

Answer 2

• Ilium, pubis, ischium

- 2 SI joints, 1 pubic symphysis, 2 hip joints

Question 3

What re the anterior landmarks of the innominates?

What are the posterior landmarks of the innominates?

Answer 3

• Pubic tubercle, Iliac crest, ASIS, AIIS

- PSIS, PIIS, Ischial tuberosity

Question 4

What is the significance of the acetabulum?

Answer 4

Not fused at birth as it is formed from 3 ossification centers
(peds XR will show unfused)

Question 5

Overuse of which ligaments can lead to innominate pain?

Answer 5

Iliiolumbar l.
posterior SI l.
Sacrospinous l.
Sacrotuberous l.

Question 6

Tension on which muscles that insert on the pelvis can affect its functional ability?

Answer 6

QL
Rectus abdominus
Ilipsoas, rectus femoris (flexors)
Glut max, hamstrings (extensors)
Glut med/min, TFL (abductors)
Piriformis (ERs)

Question 7

What are the possible motions of innominates?

Answer 7

Rotation, shear, flare

Question 8

What happens during heel strike?

What happens during toe off?

Answer 8

innominate (ipsilateral to heel) rotates posteriorly

innominate (ipsilateral to heel) rotates anteriorly

Question 9

What is a shear?

What is a flare?

Answer 9

• uneven iliac crest

- pelvis tips inward (inflare) or outward (outflare); ASIS more medial/lateral compared to normal

Question 10

What are the steps in dxing the innominate?

Answer 10

TART
Lateralization tests
Evaluate the PAMIP landmarks, focus on lat. side
use findings to determine dx

Question 11

What muscles/structures are associated with superior shear?

How about sacral SD?

Answer 11

• QL, erector spinae

- SI joint, piriformis

Question 12

What muscles are associated with posterior rotation?
Anterior rotation?
Pubic shears?

Answer 12

• Hamstrings
• Quads
• Adductors

Question 13

What are the 2 lateralization tests?

Answer 13

• ASIS compression (look for harder end feel)

- Standing flexion test (look for which one travels more superiorly)

Question 14

Dysfunctional innominates contribute to what kinds of dysfunctions?

Answer 14

LE SD
Hip SD
Altered gait mechanics
groin pain
sciatica/piriformis syndrome