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FALL2 MSK > LECTURE 4B > Flashcards

LECTURE 4B Flashcards

1
Q

SI joint pain is divided into what 3 categories

A
  1. pregnancy
  2. pathology
  3. non specific
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2
Q

SI joint dysfunction has symptoms below the knee true or false

A

false
2+ joints away = nerve

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3
Q

most people with acute LBP present with at least ___ red flag

A

80% of people with 1 RED FLAG
*need consistent patterns of pathology

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4
Q

provocation or stress tests are statistically good or poor?

A

the best!
over alignment/positional or mobility/functional tests

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5
Q

What are 6 stress tests for SI?

A
  1. FABER
  2. Distraction
  3. compression
  4. thigh thrust
  5. Gaenslen’s
  6. sacral thrust
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6
Q

what are 4 positional tests for SI?

A
  1. iliac crest heights
  2. ASIS heights
  3. PSIS heights
  4. isch tub heights
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7
Q

What are 4 mobility/functional tests for SI?

A
  1. Standing flexion
  2. seated flexion
  3. stork/marching/gillet
  4. supine to long sit test
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8
Q

What are 4 main forms of SI joint hypomobility?

A
  1. downslip
  2. upslip
  3. innominate rotation
  4. pubic lesion
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9
Q

TX for Si joint HYPOMOBILITY

A

manual + core ex

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10
Q

If I have pain in posterior sacrum (or groin),
radiating pain into thigh
increased pain with transitional movements
-pain with lumbar extension
-+ SI stress tests
+ compression test with SI belt

WHAT IS DX

A

sacroilitis!
SI joint arthritis
*treat with NSAIDs, ice, core and LE exercises

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11
Q

If I have a form closure problem (pelvic girdle instability), my ____ stability is not working

A

passive stability = form closure
*LIGAMENT/JOINT PROB
-bad friction coefficient/loose ligaments

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12
Q

If I have a lack of stability due to muscles not working well around my SI joint, I have a

A

force closure active stability problem
-TREAT WITH CORE STABILITY

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13
Q

which 4 muscles are providing external ACTIVE stability to SI joint?

A

erector spinae
glute max
lats
biceps femoris

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14
Q

which 4 muscles are providing INTERNAL active stability to SI joint? (force closure)

A
  1. TA
  2. sacral multifidi
  3. pelvic floor
  4. hip ER
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15
Q

____ fascia + muscle contractions have a ballooning effect to force close the SI joint

A

thoracolumbar fascia

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16
Q

If I have:
1. pain (persistent, severe) in LBP, sacrum, butt, hip, post thigh and/or popliteal space

  1. pain with touching pirformis, sulcus, or GT
  2. pain with sitting or squating
  3. persistent HIP ER on affected side
  4. can’t lie down or stand comfortably
  5. LE paresthesias
A

PIRFORMIS SYNDROME

17
Q

If there is a side with pain + hypermobility, and other side has hypomobility, what should you treat first

A

HYPOMOBILITY side always first
*treat dysfunction, not side of pain

18
Q

What imaging is best at catching SI joint changes?

A

MRI scans
*disc
*cancer/infection

19
Q

are bone scans appropriate for SI joint?

A

NO
radiographs (acute, osteoporosis/stress fx or trauma)
OR
MRI (best!)

20
Q

If the pelvis/pubic bone fx, will there be another fx?

A

YES (closed loop)

21
Q

joint with decreased mobility should be treated with:

A

HVLAT
mobilizations
METs
ROM exercises

22
Q

joint with excessive mobility/instability should be treated using

A

stabilization ex
NM control ex
external bracing (compression)

23
Q

joint with excessive compression signs should be treated based on…

A

the cause of compression!
1. joint fibrosis–> MOBILIZATION
2. excessive mm tone–> MET, STM, biofeedback

24
Q

What are side effects of spinal manipulation?

A

minor: soreness 1-2 days
major: ischemia, cauda equina

25
Q

exercise, yoga side effects

A

soreness
CV dysfunction
falls

26
Q

acupuncture/dry needling side effects

A

minor pain, mm soreness, fatigue, bruising
major: damage to structures, infection

27
Q

2 types of NSAIDs

A

celebrex
voltarem

28
Q

___ is injection of dextrose solution in SI joint

A

prolotherapy
*58.7% effective vs 10.2% CS injection

29
Q

____ is injection of autologous biological blood derived product

A

PRP (platelet rich plasma)
*90% effective

30
Q

What are stabilization surgical techniques for SI joint?

A
  1. pelvic fx/dislocation (plates/screws in ilium or sacrum)
  2. si joint fusion (last resort)
31
Q

post op rehab for SI joint surgery looks like…

A

early mobility (1st or 2nd day) *limit stress on healing structures

MM EX:
-isometrics, graded progression

FUNCTIONAL ACTIVITY TOLERANCE TRAINING

32
Q

What are side effects of SI joint surgery to be aware of???

A
  1. pain
  2. nausea/vomiting
  3. infection, blood clots
  4. respiratory issues
  5. GI issues
  6. nerve pain/damage
  7. increased stress (hypermobility on surrounding joints)
  8. hardware migration or failure

FALL2 MSK (18 decks)

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