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Results for “SACROILIAC JOINT”

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At least 1,711 records · Page 95Linked to original sources
PubMed2006

Analysis of iliac crest bone grafting process measures.

Autogenous iliac crest bone graft (ICBG) is the gold standard of materials for spinal fusion. We conducted a prospective observational study of posterior autogenous ICBG harvesting and used process measures to establish a normative database of bone harvesting for future comparative studies and analyses of bone graft substitutes. Between August 2000 and March 2002, we obtained posterior autogenous ICBG from 36 consecutive patients (29 men, 7 women). Mean age was 39 years (range, 22-62 years). For harvesting, the "trephine curettage" technique was performed through a skin incision separate from that of the primary surgery. Mean estimated blood loss (EBL) for harvesting was 71 mL (range, 20-200 mL). The index procedure consisted of transforaminal lumbar interbody fusion (27 patients), posterior spinal fusion (3), combined anterior and posterior spinal fusion (5), or anterior spinal fusion (1). Mean EBL for the index procedure was 790 mL (range, 150-1500 mL). Mean harvest time was 37 minutes (range, 20-51 minutes). Mean harvest volume was 38 mL (range, 25-65 mL). Donor site and sacroiliac (SI) joint were clearly visualized in 29 (81%) of the 36 patients; the SI joint (ligamentous portion) was violated in 1 patient (3%). With the emergence of bone graft substitutes, costs and benefits of autogenous ICBG harvesting will be scrutinized. This database establishes a prospective benchmark for additional EBL, harvest time, harvest volume, and SI joint violation for ICBG harvesting. To our knowledge at the time of manuscript preparation, this is the first report of routine use of postoperative computed tomography to determine incidence of SI joint violation after ICBG harvesting.

Adult↗
PubMed2000

Conservative lower back treatment reduces inhibition in knee-extensor muscles: a randomized controlled trial.

BACKGROUND: Knee-joint pathologies, such as anterior knee pain (AKP), are associated with strength deficits and reduced activation of the knee extensors, which is referred to as muscle inhibition (MI). MI is thought to prevent full functional recovery, and treatment modalities that help to reduce or eliminate MI appear necessary for successful rehabilitation. Clinical observations suggest that AKP is typically associated with sacroiliac (SI) joint dysfunction. It is unknown whether SI-joint dysfunction contributes to knee-extensor deficits and whether correction of SI-joint dysfunction alleviates MI. OBJECTIVE: The objective of this study was to assess whether conservative low back treatment reduces lower limb MI. STUDY DESIGN: In a randomized, controlled, double-blind study the effects of conservative lower back treatment on knee-extensor strength and MI were evaluated in patients with AKP. METHODS: Twenty-eight patients with AKP were randomly assigned to either a treatment or a control group. After a lower back functional assessment, the treatment group received a conservative treatment in the form of a chiropractic spinal manipulation aimed at correcting SI-joint dysfunction. The control group underwent a lower back functional assessment but received no joint manipulation. Before and after the manipulation or the lower back functional assessment, knee-extensor moments, MI, and muscle activation during full effort, isometric knee extensions were measured. RESULTS: Patients showed substantial MI in both legs. Functional assessment revealed SI-joint dysfunction in all subjects (23 symptomatic and 5 asymptomatic). After the SI-joint manipulation, a significant decrease in MI of 7.5% was observed in the involved legs of the treatment group. MI did not change in the contralateral legs of the treatment group or the involved and contralateral legs of the control group. There were no statistically significant changes in knee-extensor moments and muscle activation in either group. CONCLUSIONS: The results of this study suggest that SI-joint manipulation reduces knee-extensor MI. Spinal manipulation may possibly be an effective treatment of MI in the lower limb musculature.

Adult↗
PubMed1993

Lumbosacral dysfunctions in elite cross-country skiers.

While the incidence of injury in cross-country skiing remains relatively low, overuse problems affecting the lumbosacral region may be on the rise, particularly among elite athletes. In this study, a certified "Part A" (Canadian Physiotherapy Association) manual therapist performed lumbosacral physical assessments on 18 elite cross-country skiers and 15 normal subjects. Results indicated sacroiliac (SI) joint dysfunction occurred significantly more often in the skier population (p < 0.007). Incidences of SI joint asymmetry and lumbar spine dysfunction did not differ between groups. The predominant use of asymmetrical ski-skating techniques may play an influential role in the pathogenesis of SI joint dysfunction in elite cross-country skiers.

Adolescent↗
PubMedDate not supplied

STIR sequence in infectious sacroiliitis in three patients.

Magnetic resonance imaging (MRI) provides the most detailed evaluation of the sacroiliac (SI) joint and surrounding soft tissue. Therefore, this technique represents the most sensitive and specific method in early diagnosis of infectious sacroiliitis. Among three patients diagnosed as having infectious sacroiliitis in our hospital, the short tau inversion recovery sequence (STIR) was found to be more effective than the T1 contrast-enhanced sequence, particularly in delineating all findings of the SI joint inflammation and allowing for the early detection of septic sacroiliitis.

Adult↗
PubMed2006

Occurrence of sacroiliitis in patients with seronegative oligoarthritis.

The aim of this study was to investigate sacroiliitis in patients with seronegative oligoarthritis. Thirty consecutive patients with seronegative oligoarthritis and no other signs of spondylarthropathy were included. Sacroiliac (SI) joints were investigated by both radiography and magnetic resonance imaging. HLA B27 antigen was studied and family history was reexamined in 2006. Five patients had sacroiliitis. Additionally, 15 patients had HLA B27 antigen or family history of either psoriasis or ankylosing spondylitis. Our conclusion is that during the first decade of seronegative oligoarthritis, HLA B27 antigen, family history, and especially imaging of SI joints reveal in two thirds of the patients the spondylarthritic nature of their disease.

Adult↗
PubMed1993

Pyogenic sacroiliitis in children.

Clinical findings, roentgenograms, computed axial tomography (CT scan), radionuclide studies, and management are reviewed in seven children with pyogenic sacroiliitis (PS). High suspicion and complete examination of the pelvis and sacroiliac (SI) joint, including flexion, abduction, external rotation, and extension (FABERE) test, are essential for diagnosis. Although initial roentgenograms may be negative, CT scan will show changes indicating involvement of the SI joint. Sequential technetium and gallium scans are valuable in localizing PS. Blood cultures and direct aspiration of the SI joint will identify the infecting organism. Patients are initially treated with intravenous antibiotics. Surgical treatment is reserved for patients with advanced stage of PS.

Adolescent↗
PubMed2000

Histopathologic evidence that sacroiliitis in ankylosing spondylitis is not merely enthesitis.

OBJECTIVE: To systematically study the histopathology of sacroiliitis in ankylosing spondylitis (AS) at 5 different stages of the disease. METHODS: Two independent observers assessed 75 microscopic features in the sacroiliac (SI) joints in 12 cases of AS (5 biopsies, 7 autopsies) and in 22 control cases (all autopsies). RESULTS: In AS, synovitis, pannus formation, myxoid marrow, superficial cartilage destruction, enthesitis, intraarticular fibrous strands, new bone formation, and bony ankylosis were significantly more frequent than in control cases, in which there was more endochondral bone within deep-zone articular cartilage. Cartilaginous fusion occurred in both groups, but much earlier in AS. There was no residual synovium when the joint lumen was totally occluded. Mild but destructive synovitis and myxoid subchondral bone marrow were the earliest changes identified in AS. These lesions destroyed the adjacent articular tissues, a loss that was followed to varying degrees by fibrous scarring, woven bone, and new cartilage. The original cartilages also fused, and chondral fusion was the predominant mode of ankylosis. Both the original and the reparative cartilaginous tissues were replaced by bone. Active enthesitis occurred in 2 advanced and 3 late cases; fibrous scar tissue, presumed to represent previous enthesitis, was observed in all stages except the earliest. Paraarticular bone was at first dense, and later porotic. CONCLUSION: In the sacroiliitis of AS, two findings predominate: 1) synovitis and subchondral bone marrow changes offer a more rational explanation for widespread joint destruction than does enthesitis; and 2) an unusual form of chondroid metaplasia contributes to ankylosis.

Adult↗
PubMed1999

Early detection of sacroiliitis on magnetic resonance imaging and subsequent development of sacroiliitis on plain radiography. A prospective, longitudinal study.

OBJECTIVE: To investigate the diagnostic value of magnetic resonance imaging (MRI) in the detection of early sacroiliitis. METHODS: Twenty-five consecutive HLA-B27 positive patients with inflammatory low back pain and < or = grade 2 unilateral sacroiliitis on conventional radiography (modified New York criteria) were studied. Erythrocyte sedimentation rate, C-reactive protein, plain radiography (PR), and MRI of the sacroiliac (SI) joints were obtained at study entry and PR of the SI joints after 3 years. Each radiograph and MR image set was interpreted independently. SI joints were scored according to the modified New York Criteria for radiological sacroiliitis. MRI scans were also scored for the presence of subchondral marrow edema. The relationship between > or = grade 2 sacroiliitis (by modified New York criteria for radiological sacroiliitis) shown on MRI and the subsequent development of > or = grade 2 sacroiliitis on PR after 3 years was investigated. RESULTS: At study entry > or = grade 2 sacroiliitis was found on MRI in 36 of 50 SI joints. Edema was found in 20 of 50 SI joints. After 3 years > or = grade 2 sacroiliitis was found on PR in 21 of 44 SI joints. The positive predictive value of > or = grade 2 sacroiliitis on MRI for the development of > or = grade 2 sacroiliitis on PR after 3 years was 60%; sensitivity was 85% and specificity 47%. CONCLUSION: Our data suggest that MRI of the SI joints can be used to identify sacroiliitis earlier than PR.

Adult↗