SIJ

Question 1

who typically has SIJ presentations? (4)

Answer 1

1. preggos and post partums in 20s/30s
2. post-op
3. trauma (missed step, falls on butt, MVA)
4. asymmetrical occupational twist

Question 2

what is the diagnostic standard for SIJ?

Answer 2

intraarticular injection

Question 3

what is included in the lateral sling? 4

Answer 3

1. adductors
2. ipsi glute med
3. ipsi TFL
4. contra QL

Question 4

what is included in the post long sling? 5

Answer 4

1. tib ant
2. ipsilateral biceps femoris
3. sacrotuberous lig
4. TLF
5. contralateral ES

Question 5

what is number 1 on your differential for SIJ?

Answer 5

spondyloarthopathies such as anky spine, psoriatic arthritis, and RA

Question 6

what is force closure

Answer 6

myofascial slings: muscles that increase tension through the TLF or ligaments

Question 7

what is the prevalance of SIJ?

Answer 7

13-30% of LBP pts

Question 8

what is included in the ant oblique sling? 3

Answer 8

1. stance leg adductors
2. ipsilateral IO
3. contralateral EO

Question 9

what is form closure

Answer 9

stabilization by passive structures such as the wedge shaped sacrum and a strong ligament system

Question 10

what is the anterior anatomy of the SIJ

Answer 10

broad ant SI ligament

Question 11

how is the pelvic ring stabilized?

Answer 11

form closure and force closure

Question 12

describe SIJ innervation

Answer 12

multilevel

anterior: L2-S2
posterior: L4-S3

Question 13

what is the reference point for IS or SI mobility?

Answer 13

ASIS

Question 14

what are the symptoms of SIJ (4)

Answer 14

1. unilateral
2. non dermatomal paresthesias
3. does not refer above L5
4. butt, lower abdomen, groin, pubis, post thigh, may extend below the knee, testicles

Question 15

what is the function of the SIJ?

Answer 15

links and transmits forces between axial and appendicular skeletons

Question 16

what are the outer core muscles

Answer 16

biceps femoris
glute max
lats
mulifudus

Question 17

what is included in the post oblique sling? 3

Answer 17

1. glute med
2. TLF
3. contralateral lats

Question 18

describe (in one word) SI mobility; what are we most concerned with

Answer 18

triplanar; sagittal plane movement

Question 19

what are the nonmechanical origins of SIJ? (5)

Answer 19

1. infection
2. inflammatory pathos
3. tumors
4. metabolic disorders
5. fractures

Question 20

describe nutation (4)

Answer 20

1. sacral nod
2. pelvic outlet widens
3. tightening of the sacrotuberous ligament
4. closed pack position for the SIJ occuring when the body is vertical

Question 21

what tests would you use to determine if the SIJ is involved?

Answer 21

1. compression
2. distraction
3. thigh thrust

Question 22

what is the posterior anatomy of the SIJ

Answer 22

posterior SI ligament that becomes taught with innominate anterior rotation

Question 23

how does the SIJ contribute neurologically to the physical exam?

Answer 23

refers pain, not usually assoc with motor, reflex, or sensory changes

Question 24

what are the myofascial slings? 4

Answer 24

post oblique
ant oblique
post long
lateral

Question 25

what are SIJ aggs (9)

Answer 25

1. SLS
2. steps
3. bed and car mobility
4. sitting
5. standing up
6. crossing legs
7. lifting
8. bowel movements
9. sex

Question 26

what are the inner core muscles and what do they do

Answer 26

TA, IO, multifudus, diaphragm, pelvic floor; they increase tension on the TLF

Question 27

what are the quality of symptoms in SIJ (5)

Answer 27

1. dull ache with sharp catch
2. heavy leg
3. hip/back feels out of place
4. clicking
5. subjective paresthesias