• Title/Summary/Keyword: Sacroiliac joint

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Clinical Evaluation and Treatment of Leg Length Inequality (하지길이균차에 대환 임상평가와 치료)

  • Kim, Chang-Hwan;Kim, Jong-Deog
    • The Journal of Korea CHUNA Manual Medicine
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    • v.5 no.1
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    • pp.19-29
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    • 2004
  • Objectives : Visual check and X-ray are commonly used by chiropractors to estimate ieg length inequality, This study have three categories: diagnosis for anatomic leg length inequality; difference between anatomic and functional leg length inequality; theraphies for anatomic or functional leg length inequality. Methods : We referred to a PubMed site by using word of 'leg length [JU] J Manipulative Physiol Ther', only items with abstracts. Results : We searched 26 articles in J Manipulative Physiol Ther with the key word-Ieg length. Conclusion : 1. Radiographs were most accurate and commonly used by chiropractors to measure anatomic leg length inequality, clinically wood block, tape measure, visual check are acceptable. 2. There was no article about difference between anatomic and functional leg length inequality. 3. Heel lift was commonly used with conservative theraphy for anatomic leg length Inequality. 4. Chiropractors have not yet proved that the supposed positive effects are a result of a reduction of subluxation, The detection of the manipulative lesion in the sacroiliac joint depends on valid and reliable tests, Because such tests have not been established, the presence of the manipulative lesion remains hypothetical. Great effort is needed to develop, establish and enforce valid and reliable test procedures.

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Computer-Assisted Modified Mid-Sacrectomy for En Bloc Resection of Chordoma and Preservation of Bladder Function

  • Han, In-Ho;Seo, Young-Jun;Cho, Won-Ho;Choi, Byung-Kwan
    • Journal of Korean Neurosurgical Society
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    • v.50 no.6
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    • pp.523-527
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    • 2011
  • A 67-year-old woman presented for evaluation of severe coccygeal pain. The computed tomography scans and magnetic resonance imaging showed an asymmetric midline sacral tumor invading the right lower portion of S2. To preserve both S2 nerve roots and to obtain negative surgical margins, a modified mid-sacrectomy with an aid of a computed navigation system was performed. The sacral tumor was excised en bloc with negative tumor margins. Both S2 nerve roots were preserved and additional reconstruction was not necessary because of minimal resection of the sacroiliac joint. We report a case of a sacral chordoma which was excised en bloc with adequate surgical margins by a computer-assisted modified mid-sacrectomy. The computed navigation system may be a useful tool for tumor targeting and safe osteotomies in sacral tumor surgery via the posterior only approach.

A Case Report of the Piriformis Syndrome Treated by Caudal Steroid and Local Anesthetic (이상근 증후군 치험 1례)

  • Jeong, Chang-Young;Yeon, Myung-Ha;Im, Woong-Mo;Kim, Byu-Rha
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.149-151
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    • 1995
  • Piriformis syndrome is a syndrome of low back and leg radiating pain thought to be due to a chronic contracture of the piriformis muscle that causes irritation of the sciatic nerve. The piriformis muscle is a flat pyramidal muscle, an external rotator and abductor of the hip, originating from the front of the sacrum and inner aspect of the sacroiliac joint, then passes laterally out of the sciatic notch to attach posteriorly to the greater trochanter of the femur, the sciatic nerve passes between the two bellies of the muscle. Mechanical irritation of the sciatic nerve by an inflammatory reaction of the piriformis muscle and its fascia at this pelvic level causes pain to radiate in the dermatomal regions of the nerve roots similar to that disk entrapment. diagnosis of piriformis syndrome is made primary on the basis of history and clinical examination. The incidence is considerably higher in women, with the reported ratio of women to men of 6:1. These patients frequently present with associated symptoms of pelvic pain and/or dyspareunia. Symptoms are usually unilateral but occasionally be bilateral. We had a 42 year-old woman patient with low back and left leg radiating pain and dyspareunia treated by caudal steroid and local anesthetic.

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Four Cases of the Piriformis Syndrome Treated by Trigger Point Injection on the Piriformis Muscle (이상근 증후군 치험 4예)

  • Park, Jang-Soo;Song, Chan-Woo;Kim, Jung-Won;Shin, Dong-Yeop;Hong, Kee-Hyek
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.341-346
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    • 1995
  • Piriformis Syndrome is characterized by pain of the low back, groin, perineum, buttock, hip, posterior thigh, leg and foot. Symptoms are aggravated by sitting, prolonged combination of hip flexion, adduction, the medial rotation, or by activity. In addition, patient may complain of painful swelling of the limb and sexual dysfunction-dyspareunia in female, and impotence in male. It currently appears that three specific conditions may contribute to the piriformis syndrome: (a) myofascial pain; (b) nerve and vascular entrapment; (c) dysfunction of the sacroiliac joint. The important keys of diagnosis are history and physical examination. There is no known objective diagnostic method. We described the clinical features of four cases of piriformis syndrome and reviewed foreign literature.

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The Effects of Burning Acupuncture Therapy with Chuna Therapy for Low Back Pain Patients (요통에 대한 추나요법과 가열식 화침 병행 치료의 효과)

  • Chang, Dong-Ho;Bae, U-Yeol;Jung, Jong-Hoon;Lee, In-Seon
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.3
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    • pp.21-32
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    • 2011
  • Objectives : The purpose of this is to prove that using burning acupuncture therapy with chuna therapy can be more effective therapy for low bock pain patient. Methods : 43 patients with low back pan were divided into 2 groups; using burning acupuncture therapy with chuna therapy group and using chuna therapy only group. The patients were evaluated by visual analogue scale(VAS) and pain rating score(PRS). Results : Each group showed significant in decreasing VAS score and PRS score. After 2nd treatment, the sample group was significant mere effective in decreasing VAS. And after 3rd treatment, the sample group was significantly more effective in decreasing PRS(p<0.05). Constructive disease didn't affect the change of pain significantly. Conclusions : In this clinical study, using burning acupuncture therapy with chuna therapy group was more effective in relieving low back pain than using chuna therapy only group.

A method of bedside urethrography before catheterization in pelvic trauma in Korea: a case report

  • Hojun Lee;Sung Yub Jeong;Kun Hwang
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.451-453
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    • 2023
  • We introduce a convenient method of urethrography before catheterization for patients with pelvic trauma that can be used in a resuscitation area. A 10-mL syringe without a needle was used. X-ray contrast medium (Iohexol, 300 mg I/mL) was administered through the urethral orifice using a 10-mL syringe without needle and a simple pelvic anteroposterior film was taken (70 kilovolt [peak], 50 mAs). A 36-year-old soldier with a saddle injury from a gun barrel was taken to a trauma center. He had a pelvic fracture and complained of hematuria. Bedside urethrography above described was performed. The anterior urethra showed nonspecific findings, but dye leaked from the posterior urethra. Bedside Foley catheter insertion was attempted, but the catheter could not be advanced past the membranous urethra. Thereafter, suprapubic catheterization was performed. On the day of the injury, iliac artery embolization was carried out. The dislocated sacroiliac joint was also treated using open reduction and internal fixation. On hospital day 7, guidewire Foley insertion was performed. This bedside urethrography technique is simple and useful for pelvic fractures in which urethral injury is suspected.

Functional Taping Technique for Chronic Back Pain and Lower Extremity Pain - McConnell's Approach (만성 요통과 하지 통증에 대한 기능적 테이핑 기법 - McConnell 접근법 -)

  • Kim, Suhn-Yeop;Oh, Duck-Won;Kim, Taek-Yean
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.14 no.2
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    • pp.50-59
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    • 2008
  • Taping techniques have been usually used by physical therapists long time ago, which have been considered a useful adjunct to treatment programs for a variety of musculoskeletal disorders. Also, taping techniques may be employed as effective prophylactic methods in clinical setting because of ease application and cost effectiveness. The aims of this study were to describe background information for the management of some chronic low back pain patients with/without leg pain that don't respond to conservative treatment, to demonstrate McConnell taping as successful therapeutic strategies for treating these patients, and to provide detailed application methods of McConnell taping in order that physical therapists can readily use the taping in clinical setting. This study emphasized to illustrate biomechanical benefits of McConnell taping in controlling undesirable muscle activation by decreasing mechanical loads on specific muscles. McConnell taping may be helpful for the inhibition of overactive synergist or antagonists, the facilitation of inactive synergists, the promotion of proprioception, the optimization of joint alignment, pain reduction, and unloading of irritable neural tissue. This study provides taping examples of low back pain, sacroiliac joint dysfunction and lower extremity symptoms associated with these conditions, and discusses the possible mechanisms for their successful application.

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Treatment of Ankylosing Spondylitis (강직성 척추염의 치료)

  • Kang, Byeong-Jik;Jo, Sung-Sin;Park, Ye-Soo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.294-304
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    • 2021
  • Ankylosing spondylitis causes ankylosis of the spine due to ossification of the articular cartilage and ligaments around the vertebral body as well as the sacroiliac joint. This pathophysiology limits joint movement and, in many cases, causes pain and deformity of the spine. If this disease is left untreated, it ultimately causes ankylosis and ossification of the whole-body joints. The symptoms generally develop before age 30 years, and the gradual progression of the disease adversely affects the physical function, professional ability, and quality of life. This increases the likelihood of developing psychiatric disorders, such as depression. The authors are aware of this severity and introduce recent trends and studies to prevent surgical treatment with various medications before systemic ossification. This paper presents various surgical treatments and complications in patients who were unable to prevent progression and underwent surgical treatment.

The Usefulness of Bone Scintigraphy in SAPHO Syndrome (SAPHO 증후군에서 골신티그라피의 유용성)

  • Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.4
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    • pp.255-260
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    • 2002
  • Purpose: SAPHO syndrome is well known to various disease entities including synovitis, acne, pustulosis, hyperostosis and polyarthritis. The purpose of this study is to evaluate sicntigraphic findings and to compare with radiologic findings in SAPHO syndrome. Materials and Methods: Five patients (M:F=5.0, Age $22.8{\pm}4.78$ yrs) with SAPHO syndrome were enrolled in our study. All patients underwent whole-body bone scintigraphy with intravenous administration of 740 MBq of Tc-99m MDP. Among them, two patients were additionally perfomed SPECT of the spine to evaluate the location and extort of spinal lesion. Results: All patients were demonstrated abnormal increased uptakes in sternoclavicular joint (SC), sacroiliac joint (SI), and small joints of both hands. Among them, three patients were bilateral involvement (3/5) and two were unilateral (2/5) in SC. involvement of SI showed bilateral in four patients (4/5) and unilateral in one (1/5). SPECT images demonstrate that the lesion sites of the lumbar spine are more likely facet joints than vertebral bodies or pedicles. Conclusion: As SAPHO syndrome is the disease entity involved polyarticular joints with various dermatologic manifestations, the bone scintigraphy may be a very useful method to evaluate the location and extent of joint involvement, and to avoid inadequate surgical management or ineffective antibiotic treatment.

Freehand S2 Alar-Iliac Screw Placement Using K-Wire and Cannulated Screw : Technical Case Series

  • Choi, Ho Yong;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.61 no.1
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    • pp.75-80
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    • 2018
  • Objective : Among the various sacropelvic fixation methods, S2 alar-iliac (S2AI) screw fixation has several advantages compared to conventional iliac wing screw. However, the placement of S2AI screw still remains a challenge. The purpose of this study was to describe a novel technique of free hand S2AI screw insertion using a K-wire and cannulated screw, and to evaluate the accuracy of the technique. Methods : S2AI screw was inserted by free hand technique in sixteen consecutive patients without any fluoroscopic guidance. The gearshift was advanced to make a pilot hole passing through the sacroiliac joint and directing the anterior inferior iliac spine. A K-wire was placed through the pilot hole. After introducing a cannulated tapper along with the K-wire, a cannulated S2AI screw was installed over the K-wire. Results : Thirty-three S2AI screws were placed in sixteen consecutive patients. Thirty-two screws were cannulated screws, and one screw was a conventional non-cannulated screw. Thirty out of 32 (93.8%) cannulated screws were accurately positioned, whereas two cannulated screws and one non-cannulated screw violated lateral cortex of the ilium. Conclusion : The technique using K-wire and cannulated screw can provide accurate placement of free hand S2AI screw.