Hip Radiograph Findings in Patients Aged 40 Years and Under with Posterior Pelvic Pain
| Autor: | Heidi Prather, Shirley A. Sahrmann, Michael Bonnette, Jeffrey J. Nepple, Gregory Decker, Devyani Hunt, Abby L Cheng, Scott W. Simpson |
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| Rok vydání: | 2019 |
| Předmět: |
musculoskeletal diseases
Adult Male 030506 rehabilitation medicine.medical_specialty Ischial spine Physical Therapy Sports Therapy and Rehabilitation Physical examination Pelvic Pain Osteoarthritis Hip 03 medical and health sciences 0302 clinical medicine Femoracetabular Impingement Prevalence Medicine Hip Dislocation Humans Femoroacetabular impingement Retrospective Studies Sacroiliac joint medicine.diagnostic_test business.industry Pelvic pain Rehabilitation Age Factors Retrospective cohort study Acetabulum Sacroiliac Joint Intra-rater reliability medicine.disease Acetabular dysplasia Surgery Bone Retroversion medicine.anatomical_structure Neurology Female Neurology (clinical) medicine.symptom 0305 other medical science business 030217 neurology & neurosurgery |
| Zdroj: | PMR : the journal of injury, function, and rehabilitation. 11 |
| ISSN: | 1934-1563 |
| Popis: | Background Several sacroiliac joint (SIJ) provocative tests used to assess posterior pelvic pain involve moving and stressing the hip. It is unknown if there is a subgroup of patients with posterior pelvic pain who have underlying hip deformity that could potentially influence performance and interpretation of these tests. Objective To describe the prevalence of radiographic hip deformity and hip osteoarthritis in a group of adults 40 years old and under who met the clinical diagnostic criteria for treatment of posterior pelvic pain with an image guided intra-articular SIJ injection. Design Retrospective cohort study. Setting Tertiary university orthopedic department PATIENTS (OR PARTICIPANTS): One hundred and forty-eight patients were evaluated (83% (123/148) female; mean age 31.3 ± 6.2 years). All had completed a trial of comprehensive noninvasive treatment for posterior pelvic pain and had a minimum of three positive SIJ provocative tests on physical examination. Methods Retrospective review identified patients undergoing SIJ injection for pain recommended and performed by seven physiatrists between 2011 and 2017. Hip radiographs were read by a physician with expertise in hip measurements with previously demonstrated excellent intrarater reliability. Main outcome measurements Percentage of patients with hip deformity findings. Results No patients meeting the inclusion criteria had significant radiographic hip osteoarthritis (Tonnis ≥2 indicating moderate or greater radiographic hip osteoarthritis) and 4/148 (3%) were found to have mild radiographic hip osteoarthritis. Prearthritic hip disorders were identified in 123 (83%, 95% CI: 76, 89%) patients. For those patients with prearthritic hip disorders, measurements consistent with femoroacetabular impingement (FAI) were seen in 61 (41%) patients, acetabular dysplasia in 49 (33%) patients, and acetabular retroversion in 85 (57%) patients. Acetabular retroversion was identified in 43% (crossover sign) and 39% (prominent ischial spine) of patients. Conclusions Approximately 57% of adult patients under the age of 40 years with the clinical symptom complex of SIJ pain were found to have radiographic acetabular retroversion. This is a higher percentage than the 5%-15% found in asymptomatic people in the current literature. Further study is needed to assess links between hip structure, hip motion, and links to pelvic pain including peri and intra-articular SIJ pain. Level of evidence III. |
| Databáze: | OpenAIRE |
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