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S6- MSK 2 > Week 2- SI Joint Clinical Presentations > Flashcards

Week 2- SI Joint Clinical Presentations Flashcards

1
Q

The prevalence of SIJ dysfunction is ___%.

A

-15%

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2
Q

What is the gold standard for diagnosis of SIJ dysfunction?

A

-Local intra-articular anasthetic blocks

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3
Q

What are some common SIJ health conditions?

A
  • Spondyloarthropathies
  • Infection and Metabolic Diseases
  • Sacral Stress Fracture
  • Pregnancy Related Sacroilitis
  • Mechanical Disorders
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4
Q

Sacral Stress Fracture:

  • Pelvic ring is a closed system.
  • f the SIJ is fused, ________ stress placed on sacrum.
  • Repetitive loading can be related to ________.
  • Fractures often observed vertically at _____.
A
  • torsional
  • ambulation
  • ala
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5
Q

Sacral Stress Fractures are most common in what populations?

A
  • Athletes

- Older Adults

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6
Q

Sacral Stress Fractures (Athletes):

  • Recent increase in ______________.
  • Recent stress fracture in same area.
  • ____% of stress fractures in LE.
A
  • training intensity

- 1.7%

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7
Q

Sacral Stress Fractures (Older Adults):

  • (1) _____ SIJ and (2) diminished bone ____________.
  • Trauma
A

-fused SIJ, diminished bone density osteoporosis

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8
Q

What are some other predisposing factors to Sacral Stress Fractures?

A
  • Steroid-induced osteoporosis
  • Osteoporosis related to malignancy
  • Irradiation-induced osteoporosis
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9
Q

Sacral Stress Fracture Symptomology:

  • ____/pain into ________ (possibly groin and LE)
  • May be similar to ___________ syndrome.
A
  • LBP/pain into buttock

- cauda equina syndrome

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10
Q

Sacral Stress Fracture Physical Exam:

  • May look similar to presentations associated with _____, spinal ________, tumors.
  • _______ gait
  • TTP area of stress fracture
  • Lumbar spine ROM more likely ________.
A
  • HNP, spinal stenosis, tumors
  • antalgic gait
  • normal
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11
Q

Coccydynia:

  • What is coccydynia?
  • Flexion >___ degrees or extension >___ degrees = hypermobility.
  • Who is at more risk for coccydynia?
A
  • Ligamentous/bony injury involving coccyx.
  • > 25 degrees flexion, >20 degrees extension
  • trauma, pelvic floor injury, female (4x), higher BMI (3x)
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12
Q

Coccydynia Symptomology:

  • Pain in area of coccyx.
  • Aggravated by _________, sitting without weight shift, defecation, intercourse.
  • Aggravated with __________ motions.
A
  • transitions

- asymmetric

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13
Q

Coccydynia Physical Exam:

  • TTP coccyx
  • Sitting posture __________
  • Painful provocation testing
A

-weight-shifted

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14
Q

Coccydynia Intervention:

  • Medical (surgical excision, guided steriod injection)
  • Manual therapy (coccyx mobs)
  • PT education/ _______ ________
  • _______ ______ exercises
A
  • activity modification

- pelvic floor exercises

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15
Q

Postpartum Posterior Pelvic Pain (PPPP):

  • Pain that begins during pregnancy or within __ weeks following delivery.
  • Incidence of PPPP reported __-__%.
  • Not well understood, but theorized to be related to hormone-related ligamentous laxity and increased lordosis.
A
  • 3 weeks

- 4-78%

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16
Q

What are the (4) classifications of PPPP?

A
  • Pelvic Girdle Syndrome (involves both SI joints and pubic symphysis)
  • Symphyiolysis (involves only pubic symphysis
  • One-sided SI syndrome
  • Doube-sided SI syndrome
17
Q
  • What is the most common and second most common classification of PPPP?
  • Which is most likely to have persisting symptoms?
A
  • Double-sided SI syndrome
  • Pelvic Girdle Syndrome

-Pelvic Girdle Syndrome

18
Q

PPPP Physical Exam:

  • Findings consistent with mechanical _____
    • __________ Test
A
  • SIJD

- Active SLR Test

19
Q

SIJ Mechanical Disorders:

  • Structures that could be affected include _______, ________, and contractile units.
  • Pathoanatomy: Capsule tears thought to be a primary contributor to presentation.
  • Minimal motion typically occurs at the SIJ __-__ degrees
  • Dx best supported for local anesthetic block
A
  • capsule, ligament, contractile units

- 1-2 degrees

20
Q

SIJ Mechanical Disorders Symptomology:

  • Pain in _______/_______/_______
  • Aggravated by _________, sitting, activities that require ______ strides.
A
  • buttock/groin/thigh

- transitions, sitting, activities that require longer strides

21
Q

SIJ Mechanical Disorders Physical Exam:

  • Asymmetry with _________ _________ exam common.
  • TTP affected SIJ __________
  • Provocation with procedures that stress affected SIJ ligament/capsule structures.
  • _________ Cluster
A
  • postural landmark exam
  • stabilizers
  • Laslett’s Cluster

S6- MSK 2 (21 decks)

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