S spine Flashcards
sacral stress fx
Repetitive loading can be related to ambulation,
Fractures often observed vertically at ala
what kind of stress is put on the sacrum if the SIJ is fused
torsional
most common people to get sacral stress fx
athletes
older adults - fused SIJ
steroid induced OP
OP - by malignancy
radiation OP
s/s stress fracture
LBP/ pain into buttock
May be similar to cauda equina syndrome
PE sacral stress fx
Antalgic gait
TTP area of stress frx
Lumbar spine ROM more likely normal
hip fl test +
mechanical SIJ what
pathoanatomy
Structures that could be affected: capsule, ligament, contractile units
Pathoanatomy: Capsule tears thought to be a primary contributor to presentation
s/s SIJ mechanical
Pain in buttock/ groin/ thigh (LE proximal to the knee)
Aggravated by transitions, sitting (prolonged worse), activities that require longer strides
PE SIJ mechanical
Asymmetry with postural landmark exam common in clinic (though questionable reliability/ validity)
TTP affected SIJ stabilizers
Provocation with procedures that stress affected SIJ ligament/ capsule structures
Laslett’s Clusters
Van Der Worffs
Lasletts cluster
Thigh Thrust Test
Distraction Test
Sacral Thrust
Compression Test
Gaenslen’s Test
van Der Wurffs cluster
Thigh Thrust Test
Distraction Test
Patrick’s Sign - faber
Compression Test
Gaenslen’s Test
athletic pubalgia
Chronic pain in pubic/ inguinal region
Weakening of lower abdominal muscles & proximal hip adductors without palpable hernia
Close association with hip pathologies (FAI)
MOI athletic pubalgia
Imbalanced force transmission between lumbosacral and hip regions results in pelvic instability, repetitive stress, and inflammatory response
Repeated stress: pubic symphysis, tendons, sheath, fascia, & other soft tissue structures at bony interface
Shear load on pubic symphysis
Nerve entrapments in inguinal area
Weakness of inguinal canal’s posterior wall
inc risk factor athletic pubalgia
male
3-4 decade
hx athletic pubalgia
Insidious onset
Sports injury (pivoting/ twisting with single planted foot)
Cutting sports
s/s athletic pubalgia
Unilateral pain, progression to bilateral pain
Lower abdominal/ groin pain
Bilateral presentation over time
