Pelvis Flashcards
SIJ Dysfunction/Syndrome
SIJ Dysfunction/Syndrome
-SIJ pain syndrome refers to the pain arising from the SIJ structures.
- SIJ dysfunction generally refers to aberrant position or movement of SIJ structures that may or may not result in pain.
Patients often asymptomatic.
- SIJ problems often presents with a confusing clinical presentation. The key element in the diagnosis of SIJ syndromes
is pain.
Pain distribution
Ipsilateral buttock pain 94%
Lower lumbar pain 74%
Lower extremity pain 50%, with 28% of these lower
extremity pains going distal to the knee
Groin pain 14%
Pain goes all the way into the foot 13%
Younger patients are more likely to refer pain distal to
the knee.
Pain quality: The pain is described as a dull ache or sharp, stabbing, or knifelike.
Causes of SIJ disorders
Mechanical disorders
(Hypomobility/hypermobility)
Degenerative changes
Infections (osteomyelitis)
Osteitis condensans illii (OCI)
Examination
Localised tenderness - dull, aching, unilateral pain around PSIS (not
at the mid-line unless lumbar spine is also involved)
Abnormal motion palpation findings (Gillets test, prone spring,
seated trunk flexion)
Pain on active and passive movements
Positive orthopedic provocation tests
Active movements that stress the SIJ
Coccydynia
Coccydynia refers to pain in the region of the coccyx
-The mean age of onset is 40 years and the prevalence is 5X greater in women than men
-The majority of cases occur in conjunction with either a subluxated or hypermobile coccyx, and it has been proposed that this pathologic instability may give rise to chronic inflammatory changes leading to degeneration of this structure
- Many of these patients will report a history of an antecedent traumatic event, which has been shown to be associated with coccygeal instability, particularly posterior subluxation.
Signs and symptoms:
* Pain in and around the coccyx without significant low back pain or pain radiation or referral
* pain is associated with sitting and is exacerbated when rising from a seated position.
* Many patients will also feel a frequent need to defecate or pain with defecation.
* Others may report relief of their pain when they sit on their legs or on one buttock
