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Sacroiliac Joint Dysfunction

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Small joint that lies at the junction of the sacrum and the ilium. ... or around the region of the sacroiliac joint. ... Sacroiliac Joint Pain and Dysfunction. ... – PowerPoint PPT presentation

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Title: Sacroiliac Joint Dysfunction


1
Sacroiliac Joint Dysfunction
  • By Kelsy Ney

2
Background
  • Also known as SI joint (pain) syndrome, SI joint
    sprain, or Sacroiliitis.
  • This joint is under question by many

3
Anatomy
  • Small joint that lies at the junction of the
    sacrum and the ilium.
  • 2 ligaments- Anterior and posterior sacroiliac
    ligaments
  • Little mobility
  • Transfers load from upper body to the lower body.
  • Provides shock absorption for the spine.

4
What is it?
  • Term used to describe pain in or around the
    region of the sacroiliac joint.
  • It is assumed to be due to malalignment, abnormal
    movement, or trauma to the area.

5
History
  • MOI
  • Trauma/ Injury
  • Leg length discrepancy
  • Muscle imbalance
  • Pelvic asymmetry
  • Weight gain
  • Poor posture
  • Altered gait
  • ADLs
  • Limitations?
  • AGG
  • Bending, lifting, sitting, climbing stairs
  • ALL
  • Sounds
  • Popping or clicking

6
History Contd
  • Pain is key!!!
  • Dull ache, sharp, or stabbing
  • Distribution to the buttocks, back of thigh, and
    lower back
  • Unilateral or bilateral
  • Worse
  • When sitting for long periods of time
  • When performing twisting/rotary motions
  • Morning stiffness
  • Resolves with exercise, depending on pain.
  • Pain over PSIS

7
Observation
  • Forward bending
  • Normal or blocked movement
  • PSIS on injured side moves sooner than normal
    side
  • Straight leg raises
  • Increases pain after 45 degrees
  • Side bending
  • Painful side will increase pain

8
Observation Contd
  • What does this mean?
  • Anterior or posterior rotation of one side of the
    pelvis relative to the other.

9
Special Tests
  • Distraction Test
  • Attempting to pull apart joint
  • Compression Test
  • Pt lies on side, apply downward compression to
    the lateral pelvis.
  • () pain
  • Patricks Test
  • Gaenslens Test
  • Supine, Injured leg at side of table, bring both
    K to chest, let injured one slowly extend and
    lower off table. () pain.

10
Prevention
  • Warm- up properly
  • Stretching muscles
  • Deep heat
  • Strengthening exercises
  • Avoiding painful activities

11
Management
  • Ice and rest
  • NSAIDs
  • Modalities to reduce pain.
  • Supportive brace to correct asymmetry.
  • Strengthening exercises
  • Severe cases
  • Cortisone injection

12
Differential Diagnosis
  • Sciatica
  • Difference in how far radiating pain goes.
  • Back Pain
  • Dislocation
  • Fracture
  • Could be causing pain and limited ROM

13
Works cited
  • Ford, Chris. The Sacroiliac Joint. Available at
    www.abcphysicaltherapy.com/Secondary20Pages/sacro
    iliac_joint.htm. Accessed March 26, 2007.
  • Henley, Cynthia and Kathryn Wollam. Sacroiliac
    Pain A Physical Therapy Perspective. Post-Polio
    Health. 2006 22 1-3.
  • Magee, David J. Orthopedic Physical Assessment.
    Saunders Elsevier, MO 2006.
  • Prentice, William E. Arnheims Principles of
    Athletic Training. McGraw-Hill Companies, Inc.
    NY 2006.
  • Riddle, Daniel L, and Janet K Freburger.
    Evaluation of the Presence of Sacroiliac Joint
    Region Dysfunction Using a Combination of Tests
    A Multicenter Intertester Reliability Study.
    Physical Therapy. 2002 82 772-781.
  • Sherman, Andrew L. Sacroiliac Joint Injury.
    Available at www.emedicine.com/SPORTS/topic116.htm
    . Accessed March 26, 2007.
  • Walker, Brad. Sacroiliac Joint Pain and
    Dysfunction. Available at www.thestretchinghandbo
    ok.com/archives/sacoiliac-joint-pain.php.
    Accessed March 26, 2007.
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