Diastasis symphysis pubis
| Diastasis symphysis pubis | |
|---|---|
 | |
| Post traumatic diastasis of symphysis pubis | |
| Classification and external resources | |
| Specialty | obstetrics gynecology, rheumatology |
| MeSH | D046548 |
Diastasis symphysis pubis is the separation of normally joined pubic bones, as in the dislocation of the bones, without a fracture.
Contents
Cause[edit]
External forces such as falling from a horse or a car accident can result in this type of injury to the symphysis pubis.
Diagnosis[edit]
This abnormally wide gap can be diagnosed by radiologic studies such as x-ray, MRI, CT scan or bone scan. Manual testing by a healthcare professional can also be used. The patient is placed in various positions and pressure is applied in such a way that it provokes pain and maybe movement in the pubis.
Differential diagnosis[edit]
- In bladder extrophy[1] there is a gap between the pubis, which are joined by a strong interpubic ligament.
X-ray[edit]
An X-ray film will show a marked gap between the pubic bones, normally there is a 4–5 mm gap but in pregnancy, hormonal influences cause relaxation of the connecting ligaments and the bones separate up to 9 mm. To demonstrate instability of the joint the patient is required to stand in the "flamingo" position, (standing with weight on one leg and the other bent).[2] A vertical displacement of more than 1 cm is an indicator of symphysis pubis instability.[3] A displacement of more than 2 cm usually indicates involvement of the sacroiliac joints.
CT scan and MRI[edit]
Both diagnostic machines can produce detailed cross sections of the pelvic area. Images will show degrees soft tissue injury, inflammation of the subchondral region and the bone marrow [4] and any abnormal posturing of the pelvic joints.
Bone scan[edit]
A bone scan is able to determine areas of bone inflammation.
Management[edit]
![[icon]](/wiki/File:Wiki_letter_w_cropped.svg){kind=small} | This section is empty. You can help by adding to it. (December 2017) |
References[edit]
- ^ http://www.bartleby.com/107/255.html (end of page)
- ^ An Analysis of Pubis Symphysis Misalignment Using Plain Film Radiography Ruch WJ, Ruch BM. J Manipulative Physiol Ther. 2005;28(5):330-335
- ^ Vertically Unstable Pelvic Fractures Fixed with Percutaneous Iliosacral Screws: Does Posterior Injury Predict Fixation Failure? Damian R. Griffin, MA, FRCS (Orth); Adam J. Starr, MD; Charles M. Reinert, MD; Alan L. Jones, MD; Shelly Whitlock, CCRA; University of Texas Southwestern Medical Center, Dallas, TX
- ^ Magnetic resonance imaging changes of sacroiliac joints in patients with recent-onset inflammatory back pain: inter-reader reliability and prevalence of abnormalities. Arthritis Research & Therapy 2006, 8:R11 doi:10.1186/ar1859. Liesbeth Heuft-Dorenbosch1, René Weijers, Robert Landewé1, Sjef van der Linden1, Désirée van der Heijde1
