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Orthopaedic Conditions > Pelvic conditions > Flashcards

Pelvic conditions Flashcards

1
Q

Sacroiliac joint pain epidemiology

A

Arthritis
Trauma
Pregnancy and post-partum
Inflammatory conditions

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2
Q

Age groups affected by SIJ pain

A

More common in females
Increased frequency in 40-55 year olds

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3
Q

Risk factors of SIJ pain

A

Older age
Arthritis
Pregnancy
Trauma

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4
Q

Clinical presentation of SIJ pain

A

Low back and/or buttock pain with or without lower extremity pain
Sharp, stabbing and /or shooting pain in buttock which extends down post thigh, usually not past knee
Pain frequently misdiagnosed as radicular pain
Difficulty sitting for too long

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5
Q

Prognosis for SIJ pain

A

Dependent on severity, acute= several days- weeks
Chronic- persists for more than three months

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6
Q

Osteitis pubis epidemiology

A

Overuse of hip and leg muscle
Particularly common in athletes who play sports involving changing direction, kicking or pivoting
Repetitive stress on pelvic bones

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7
Q

Age groups affected by osteitis pubis

A

Common in men aged 30-50
Woman affected more in mid 30s

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8
Q

Risk factors of osteitis pubis

A

Overusing hip and leg muscles particularly in sport

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9
Q

Clinical presentation of osteitis pubis

A

Inflammation around pubis
Complaint about groin or lower abdomen pain
Pain over pubis symphysis

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10
Q

Prognosis for osteitis pubis

A

Can take up to 6 months
Most return by 3 months

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11
Q

Illiopsoas bursitis

A

Inflammation of bursa located beneath ilioposaos muscle

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12
Q

Bursa meaning

A

Fluid filled sac between bones, muscles, tendons, and skin
Provides cushion and reduces friction

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13
Q

Ilioposaos bursitis epidemiology

A

Arthritis (rheumatoid, psoriatic)
Acute trauma
Oversue injury

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14
Q

Age groups affected by iliopsoas bursitis

A

After age 40

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15
Q

Risk factors of ilipsoas bursitis

A

Repetitive motion
Overuse joints, tendons, and muscles
Rheumatoid arthritis

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16
Q

Clinical presentation of iliopsoas bursitis

A

Pain is variable
Pain and tenderness that radiates deep in groin or front of hip radiating around and down the front of the thigh towards knee
Increased pain with hip flexion

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17
Q

Prognosis of iliopsoas bursitis

A

Can take several weeks to heal
Typical recovery 6-8 weeks
Anti-inflammatory drugs
Stretching of hip flexors and later stretching programme

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18
Q

Piriformis syndrome

A

Conditions in which piriformis muscle spasms and causes buttock pain
Can also irritate nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into foot
Uncommon cause of sciatica
Diagnosis of exclusion- facet arthropathy, spinal stenosis, and lumbar muscle strain must be ruled out fist

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19
Q

Epidemiology of piriformis syndrome

A

Injury
Swelling
Muscle spasm
Scar tissue on piriformis

20
Q

Age groups affected by piriformis syndrome

A

No particular age
Females are more likely due to anatomical differences

21
Q

Risk factors of piriformis syndrome

A

Increased BMI
Occupational related injury to piriformis (e.g., prolonged sitting, driving)

22
Q

Clinical presentation of piriformis syndrome

A

Pain in buttock with or without ipsilateral radiation, down post thigh
Pain is exacerbated with activity, prolonged sitting, or walking
Pt may walk with a limp and hold the leg in a shortened externally rotated position while supine
Tenderness of greater sciatic notch
Made worse with deep laterally directed palpation on pelvic or rectal examination
May be trigger point over piriformis with radiation down sciatic distribution

23
Q

Prognosis of piriformis syndrome

A

Most episodes go away in a few days or weeks with rest and simple treatment
Stretching

24
Q

Ischiogluteal bursitis

A

Rare
Infrequently recognised soft tissue mass of the buttock region

25
Q

Epidemiology of ischiogluteal bursitis

A

most common in people sedentary careers, constant irritation of ischial bursae due to prolonged sitting on hard surfaces

26
Q

Risk factors of ischiogluteal bursitis

A

Sitting for too long on hard surface
Direct trauma to area
Injury to hamstring or tendon through exercise

27
Q

Clinical presentation of ischiogluteal bursitis

A

Palpable, tender mass on buttock
Pain in upper thigh following exercise or sitting for a long time

28
Q

Prognosis of ischiogluteal bursitis

A

Will not spontaneously remit
Pain may be abate with a period of lay-off or treatment
Reiterating activity will still lead to excessive friction on bursa, causing inflammation and pain

29
Q

Levator ani syndrome

A

Non-relaxing pelvic floor dysfunction
Pelvic floor muscles are too tight
Pelvic floor supports rectum, bladder and urethra

30
Q

Epidemiology of levator ani syndrome

A

Exact cause unknown
Related to not urinating when needing to, continuing intercourse when its painful, injury to pelvic floor from surgery or trauma

31
Q

Who is more affected by levator ani syndrome

A

More common in women

32
Q

Risk factors of levator ani syndrome

A

Pelvic floor surgery
Post vaginal childbirth

33
Q

Clinical presentation of levator ani syndrome

A

Constant or frequent dull pain in rectum caused from spasm in levator ani muscle
Pain usually unilateral, more specifically on left + higher up, tends to be more tender
Pain in lower back which may spread to groin or thighs
May experience constipation, problems passing bowel movements or strain
Additional symptoms include bloating, needing to urinate often, bladder pain with urination

34
Q

Prognosis of levator ani syndrome

A

Massage, sitz bath, muscle relaxers will improve symptoms

35
Q

Coccydynia

A

Pain in coccyx

36
Q

Coccydynia epidemiology

A

Falling back into sitting position
Repeated micro trauma (e.g., prolonged sitting in inappropriate position, cycling)
Degenerative changes in sacrococcygeal and intercoccygeal joints
Increased muscle tightness of pelvic floor muscle

37
Q

Groups affected by coccydnia

A

Women 5x more likely than men to develop coccydynia (pregnancy related injuries, often caused by pressure from baby’s head)

38
Q

Risk factors of coccydynia

A

Birth trauma
Increased BMI

39
Q

Clinical presentation of coccydynia

A

Tenderness in direct touching of coccyx area, pubococygeal and sacrococcygeal ligament
Pain during defecation

40
Q

Prognosis of coccydynia

A

Conservative approaches- rest, ring shaped cushions, etc
Medication- NSAIDs
Manual therapy

41
Q

SIJ instability Hx

A

Chronic SI P
Possible repeatable ‘clunk’ of SIJ
May occur during or shortly after pregnancy

42
Q

SIJ instability SSx

A

Inc range of motion

43
Q

SIJ instability DDx

A

SIJ dys
Lsp instability

44
Q

SIJ dysfunction Hx

A

Insidious onset of local P or discomfort
May be due to fall on sacrum

45
Q

SIJ dysfunction SSx

A

Tender to palp
Limited Jt play
Local myospasm
Bone out of place

46
Q

SIJ DDx

A

Lumbar sprain/strain

Orthopaedic Conditions (11 decks)

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