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DPT 751 - Musculoskeletal III > Sacroiliac Joint Dysfunction (SIJD)Examination and Treatment > Flashcards

Sacroiliac Joint Dysfunction (SIJD)Examination and Treatment Flashcards

1
Q

What is Sacroiliac Joint Dysfunction (SIJD)?

A
  • SIJD refers to pain in the sacroiliac joint region caused by dysfunction in the joint itself, often presenting as low back pain.
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2
Q

What are common causes of SIJD?

A

Common causes include pregnancy, trauma (e.g., falls, motor vehicle accidents), and certain repetitive activities like running or lunges.

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3
Q

What is the incidence and prevalence of SIJD?

A

SIJD is more common in females and may affect 10% to 25% of patients with persistent mechanical low back pain below L5.

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4
Q

What are the symptoms associated with SIJD?

A

Symptoms include pain with transitional movements, running, lying on the affected side, and trauma-related pain.

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5
Q

What activities exacerbate SIJD pain?

A

Activities that exacerbate pain include sit to stand, getting out of a car, running, lunges, and pelvic end range movements.

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6
Q

What are the gender differences in SIJD?

A

SIJD is relatively equal in mobility between men and women from ages 19-45, but after 60, ankylosis occurs in 82% of males and 30% of females.

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7
Q

What is the biopsychosocial model of pelvic girdle pain?

A

It emphasizes the interaction between biological, psychological, and social factors in the development and management of pelvic girdle pain.

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8
Q

What are common differential diagnoses for low back pain vs. SIJD?

A

Common differential diagnoses include mechanical low back pain, discogenic pain, facet joint pain, and muscular dysfunction.

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9
Q

What is the role of pain provocation tests in diagnosing SIJD?

A

Pain provocation tests help identify SIJ pain, with clusters of these tests increasing the probability of accurate diagnosis.

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10
Q

What is the role of imaging in diagnosing SIJD?

A

Imaging has limited evidence for diagnosing SIJD, with more reliance on clinical tests and patient history.

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11
Q

What is the Thigh Thrust Test?

A

The Thigh Thrust Test involves flexing the hip to 90°, applying axial force through the femur to reproduce SIJ pain.

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12
Q

What is the Distraction/Gapping Test?

A

The Distraction Test involves applying pressure to the ASIS to reproduce SIJ pain.

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13
Q

What is the SI Joint Compression Test?

A

The Compression Test involves applying pressure over the iliac crest to reproduce SIJ pain.

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14
Q

What is the Sacral Thrust Test?

A

The Sacral Thrust Test involves delivering an anteriorly directed thrust over the sacrum to reproduce SIJ pain.

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15
Q

What is Gaenslen’s Test?

A

Gaenslen’s Test involves flexing one hip while extending the opposite hip to apply torque to the pelvis and reproduce SIJ pain.

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16
Q

What is the Hip Test for SIJ involvement?

A

The Hip Test involves placing the leg in a figure-four position and applying pressure to assess SIJ-related pain.

17
Q

What are motor control/stabilization exercises for SIJD?

A
  • gluteus maximus strengthening
  • supine clamshells
  • resisted hip hinge exercises
18
Q

What are mobilization techniques for SIJD?

A

Mobilization techniques include manual therapy techniques like muscle energy techniques and joint mobilizations.

19
Q

What is the use of SI joint belts and kinesiotaping?

A

SI joint belts and kinesiotaping provide external support to the SIJ, helping stabilize and reduce pain.

20
Q

What are muscle energy techniques for anterior innominate rotation?

A

These techniques involve the patient resisting against the therapist’s force to correct the anterior rotation of the innominate.

21
Q

What is the upslip correction technique?

A

Upslip correction involves applying traction to the leg to pull the pelvis down, often combined with muscle energy contractions.

22
Q

What is the treatment for innominate outflare?

A

Treatment includes placing the leg in adduction and internal rotation, and resisting against abduction to correct the outflare.

23
Q

What is the treatment for innominate inflare?

A

Treatment includes abducting the thigh and resisting against adduction to correct the inflare.

24
Q

What are manual correction techniques for pubic symphysis?

A

Techniques include resisted abduction and adduction exercises to realign the pubic symphysis.

25
Q

What are specific exercises for SIJ stability?

A

Exercises include bridges, clamshells, resisted hip movements, and pelvic floor strengthening exercises.

26
Q

How effective are physiotherapy interventions for SIJD?

A

Physiotherapy interventions like manipulation, exercise, and kinesiotape are effective in reducing pain and disability associated with SIJD.

27
Q

What is the role of specific stabilizing exercises in reducing pain and disability?

A

Specific stabilizing exercises target deep and superficial muscles to improve stability and reduce pain.

28
Q

What are non-mechanical sources of SIJ pain?

A

Non-mechanical sources include ankylosing spondylitis, reactive arthritis, and psoriatic arthritis.

29
Q

How does ankylosing spondylitis relate to SIJ pain?

A

Ankylosing spondylitis can cause inflammation and pain in the SIJ, often affecting younger males.

30
Q

What is reactive arthritis (Reiter’s Syndrome)?

A

Reactive arthritis is an inflammatory condition that affects the joints, including the SIJ, and is characterized by conjunctivitis, urethritis, and arthritis.

31
Q

How does psoriatic arthritis affect the SIJ?

A

Psoriatic arthritis can cause pain and inflammation in the SIJ, contributing to lower back pain.

32
Q

How should SIJD be managed during pregnancy?

A

Management includes exercises for pelvic stability, use of SI belts, and gentle manual therapy techniques.

33
Q

What is the impact of age on SIJ mobility?

A

Mobility decreases with age, with higher rates of ankylosis in older males compared to females.

34
Q

What is the evidence against the ‘bone out of place’ model?

A

Current literature does not support the ‘bone out of place’ model, favoring pain provocation tests over asymmetry evaluations.

35
Q

Why are pain provocation tests preferred over asymmetry evaluations?

A

Pain provocation tests have higher reliability and diagnostic accuracy for SIJD compared to asymmetry evaluations.

36
Q

What are the guidelines for selecting therapeutic exercises for SIJD?

A

Therapeutic exercises should be selected based on whether the joint is too tight or too loose, aiming to diversify the patient’s movement patterns.

37
Q

What is the Sacroiliac Joint Exercise Algorithm?

A

The algorithm involves using SI belts, stability exercises, and specific maneuvers like Gaenslen’s manipulation to address SIJ pain.

38
Q

What is the role of pelvic floor exercises in SIJ pain management?

A

Pelvic floor exercises help stabilize the SIJ, reducing pain and improving function.

DPT 751 - Musculoskeletal III (15 decks)

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