Chronic pelvic girdle relaxation
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Abstract
A 24-year-old pregnant woman presented with severe pain in her symphysis pubis and right buttock. The iliac gapping test evoked pain in the right sacroiliac joint and symphysis pubis. The iliac compression test evoked pain in the symphysis pubis. The Patric test evoked pain in the symphysis pubis and right sacroiliac joint. Radiographs of the pelvis showed no abnormality except for a 7 mm separation of the symphysis pubis and mild bilateral acetabular dysplasia. Four and a half years later and 12 weeks into her next pregnancy she again complained of moderate pain in the symphysis pubis. Computed tomography, magnetic resonance imaging and bone scintigraphy using99mTc MDP showed no abnormality in the pelvis and spine. Laboratory data were normal. An injection of steroid and lidocaine into the right sacroiliac joint dramatically improved the pain. Eight years after first delivery she could walk independently, but often complained of mild to severe pelvic pain which was relieved with non-steroidal anti-inflammatory drugs.
Key words
Pregnancy sacroiliac joint symphysis pubis choronic pelvic girdle relaxationPreview
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References
- 1.Driessen F, Postpartum pelvic arthropathy with unusual features,Br J Obstet Gynecol 94, 870–872 (1987).Google Scholar
- 2.Hechman JD, Sassard R, Current concept review. Musculoskeletal considerations in pregnancy,J Bone Joint Surg 76A, 1720–1730 (1994).Google Scholar
- 3.Kristiansson P, Svardsudd K, von Schoultz B, Serum relaxin, symphyseal pain, and back pain during pregnancy,Am J Obstet Gynecol 175, 1342–1347 (1996).PubMedCrossRefGoogle Scholar
- 4.Hansen A, Jensen DV, Larsen Eet al., Relaxation is not related to symptom-giving pelvic girdle relaxation in pregnant women,Acta Obstet Gynecol Scand 75, 245–249 (1996).PubMedCrossRefGoogle Scholar
- 5.Dietrichs E, Kogstand O, ‘Pelvic girdle relaxation’ suggested new nomenclature,Scan J Rheumatol Suppl 88, 3–3 (1991).Google Scholar
- 6.MacLennen AH, The role of the hormone relaxin in human reproduction and pelvic girdle relaxation,Scand J Rheumatol Suppl 88, 7–15 (1991).Google Scholar
- 7.MacLennen AH, Maclennan SC, Symptom-giving pelvic girdle relaxation of pregnancy, postnatal pelvic joint syndrome and developmental dysplasia of the hip,Acta Obstet Gynecol Scand 76, 760–764 (1997).CrossRefGoogle Scholar
- 8.Walheim GG, Selvik G, Mobility of the pelvis symphysis.In vivo measurements with an electromechanic method and a roentogen stereophotogrammetric method,Clin Orthop 191, 129–135 (1984).PubMedGoogle Scholar
- 9.Edeiken-Monroe BS, Browner BD, Jackson H, The role of standard roentgenograms in the evaluation of instability of pelvic ring disruption,Clin Orthop 240, 63–76 (1989).PubMedGoogle Scholar
- 10.Vleeming A, Buyruk HM, Stoeckart Ret al., An integrated therapy for peripartum pelvic instability: a study of the biomechanical effects of pelvic belts,Am J Obstet Gynecol 166, 1243–1247 (1992).PubMedGoogle Scholar
- 11.Dhar S, Anderton JM, Rupture of symphysis pubis during labor,Clin Orthop 283, 252–257 (1992).PubMedGoogle Scholar