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Sacroiliac Joint Syndrome - Coggle Diagram
Sacroiliac Joint Syndrome
Subjective
Can extend down thigh but not past knee.
C/O pain while sitting, lying on effected side and stairs.
Pain localised over the buttock (over the joint). Described as sharp, dull, achy, stabbing, or shooting pain
Pregnant women and people who lead sedentary lifestyles have a greater chance to be effected.
Difficult to distinguish between LBP. As pain can be felt there too.
Objective
Pain provocation when mechanically stressed i.e., bending forwards.
Neuro testing should be clear.
May present with tenderness around PSIS on palpation.
Virtually impossible to palate the movement of SIJ.
Strength testing around hip.
Research
?!
?!
Al-subahi et al 2017, systematic review - Manipulation, exercise and kinesio tape are effective in the treatment of pain, disability and pelvic asymmetry in SIJD
Why this and nothing else?
Testing - Laslett
Think difference between radicular pain and somatic referred pain.
Differentials
Piriformis syndrome.
Deep gluteal pain syndrome.
Radicular pain.
NSLBP
Pathology
Malalignment or abnormal motion can often be cause.
Excessive or restricted joint movement.
Common term used to describe pain in the sacroiliac joint.
Treatment
Clamshell. Side plank. Fire hydrants. Iliopsoas marc. Bridging. Back extensions. Superman's. Lat pull down.
Stay active within pain limits. Education around condition.
Tests
Cluster of Laslett (Sens 88%, Spec 78%)
Supine, stand on asymptomatic side, flex patients 90 degree of hip flexion with one hand under sacrum, Apply downward pressure through femur (hand on knee) 3-6 thrusts.
Patient lie on asymptomatic side with hips flexed to 45 and knees at 90. Behind patient both hands on ant rim of ilium, downward thrusts 3-6.
Supine leg extended, on symptomatic side, both hands on ASIS, 3-6 thrusts in dorsal lateral direction.
Prone lying, palm on s2, downward pressure, 3-6 thrusts.
Looking for provocation of familiar pain, be gentle to start. Outcome 2/4 positive tests needed to diagnose symptomatic SIJ joint. Go until you have 2 positive, no further testing needed.
Active straight leg raise.
Tough one need more info