An anatomical ultrasound study of the long posterior sacro‐iliac ligament

This article focuses on the (functional) anatomy and biomechanics of the pelvic girdle and specifically the sacroiliac joints (SIJs). The SIJs are essential for effective load transfer between the spine and legs. The sacrum, pelvis and spine, and the connections to the arms, legs and head, are functionally interrelated through muscular, fascial and ligamentous interconnections. A historical overview is presented on pelvic and especially SIJ research, followed by a general functional anatomical overview of the pelvis. In specific sections, the development and maturation of the SIJ is discussed, and a description of the bony anatomy and sexual morphism of the pelvis and SIJ is debated. The literature on the SIJ ligaments and innervation is discussed, followed by a section on the pathology of the SIJ. Pelvic movement studies are investigated and biomechanical models for SIJ stability analyzed, including examples of insufficient versus excessive sacroiliac force closure.

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“…; Moore et al. ). The lateral expansion of the LDL, directly caudal to the PSIS, ranges from 15 to 30 mm.…”

Section: Ligaments Supporting the Sijmentioning

confidence: 98%

The sacroiliac joint: an overview of its anatomy, function and potential clinical implications

et al. 2012

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“…The depth of the SPL was the least reproducible measurement, which is not surprising considering the difficulties experienced defining this by dissection. A previous report of using ultrasound to measure the thickness of the long posterior sacroiliac ligament described similar difficulties (Moore et al, ). The use of traditional embalming fluids may also increase the difficulties of visualizing structures by ultrasound (Schramek et al, ).…”

Section: Discussionmentioning

confidence: 89%

Sonographic anatomy of the pubic symphysis in healthy nulliparous women

Becker

Stringer

Jeffery³

et al. 2014

Clinical Anatomy

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Pregnancy-related symphyseal pain is a condition commonly encountered by clinicians but its pathogenesis is poorly understood. The pubic symphysis is readily visualized with ultrasound, yet the normal sonographic anatomy of the joint has not been accurately documented. This study aimed to describe the anatomy of the pubic symphysis in healthy, nulliparous women using ultrasound. An experienced and inexperienced sonographer scanned the joint in 30 female volunteers (mean age 26 years). Interobserver and intraobserver reliability of ultrasound measurements were examined and the accuracy of these measurements was validated by ultrasound and dissection of six female cadaver pelves (mean age 75 years). In healthy young women, pubic symphysis morphology varied, and six categories of anterosuperior joint shape were defined. Mean values of several anatomic parameters were obtained in supine and standing positions: joint width (widest 10.1 mm, narrowest 2.6 mm); superior pubic ligament (SPL) length and depth (41.4 and 3.4 mm, respectively); and pubic crest length (left 24.4 mm, right 24.4 mm). Statistically significant relationships between SPL width and depth and anthropometric variables (body mass index, pelvic width, and body fat percentage) were established. Larger ultrasonographic measurements, such as wide joint width and SPL length, could be measured more reliably than smaller measurements, such as narrow joint width and SPL depth, in both healthy volunteers and cadavers. Findings from this study provide normative reference data for examination of the pubic symphysis in pregnant women and may therefore be relevant to understand pregnancy-related symphyseal pain.

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“…[35,36] No No Yes [37,39,40,42] Yes [37,39,40] No No Yes [44,45] Yes [46] Yes [47] Yes [49] No No US can show structural changes in the fascia layers.…”

Section: Intervertebral Discsmentioning

confidence: 99%

“…First, Moore et al did an anatomical US study of PSL's long part in cadavers and in healthy young women [44]. Subjects were examined in lateral decubital position using linear 7.5-10 MHz transducer.…”

Section: The Muscles Of the Lower Back And Pelvismentioning

confidence: 99%

Diagnostic value of musculoskeletal ultrasound in patients with low back pain – a review of the literature

2018

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Low back pain (LBP) occurs in various groups of the population, affects men and women equally, and is among the major reasons for rheumatological or orthopedic consultations. Its prevalence increases steadily with age and the rate of recurrence within one year could reach 44% [1]. Many imaging modalities are available to clinicians for evaluating LBP. The application of these modalities depends mainly on the working diagnosis, the urgency of the clinical problem, the availability, and the comorbidities of the patient [2]. Conventional radiography (CR) and computerized tomography (CT) are associated with radiation exposure and show primarily the bony elements of the lower back. Their widespread use in the 20th century might be among the reasons why paraspinal soft tissues have somehow been neglected as a cause for LBP [1]. Magnetic resonance imaging (MRI) shows both bony and soft tissue structures in the axial skeleton, but its use is hampered by the duration of the examination, its relatively high costs, its limited availability (mainly in the tertiary centers) and the contraindications for this diagnostic modality [2].Musculoskeletal ultrasound (US) is a safe, fast, inexpensive, and widely available imaging modality that is very well tolerated by patients [3]. It allows multiplanar and dynamic examinations of the musculoskeletal system and can show the soft tissues in great anatomical detail. US is used by a growing number of physicians and the list of its applications in rheumatology and orthopedics is growing [4].Therefore, the question of the possible diagnostic application of US in such a common condition as LBP is very relevant to the clinical practice. On one hand, this could decrease the radiation exposure associated with CR and CT, and reduce the costs paid for MRI. The effect could be even bigger in time, as LBP is frequently a chronic or recurrent disease [1]. On the other hand, by AbstractPatients with low back pain (LBP) frequently undergo various imaging studies in the pursuit of a more precise diagnosis. Ultrasound (US) has the advantage of being a widely available, multiplanar, fast and radiation-free diagnostic tool. Moreover, compared to most of the other imaging modalities, it is particularly efficient in the visualization and assessment of soft tissues. Consequently, the question about the possible diagnostic application of US in such a common pathology as LBP is very relevant to the clinical practice. For this reason, we performed a review of the literature on the diagnostic value of US in different conditions that could cause LBP. We hereby discuss available studies on the diagnostic application of US in spinal canal stenosis and disc herniation (probably of historical significance only), as well as in the pathology of soft tissue structures like the lumbar and pelvic ligaments, muscles and entheses, the thoracolumbar fascia and the sacroiliac joints (maybe of greater importance nowadays). The evidence for the diagnostic value of US is not equivocal, though promising for some of the causati...

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An anatomical ultrasound study of the long posterior sacro‐iliac ligament

Cited by 17 publications

References 22 publications

The sacroiliac joint: an overview of its anatomy, function and potential clinical implications

The sacroiliac joint: an overview of its anatomy, function and potential clinical implications

Sonographic anatomy of the pubic symphysis in healthy nulliparous women

Diagnostic value of musculoskeletal ultrasound in patients with low back pain – a review of the literature

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