MRI of the pelvic ring joints postpartum: Normal and pathological findings

Abstract

Purpose:To assess the joints of the pelvic ring postpartum and to discern normal postpartum findings and pathologic lesions using MRI. Materials and Methods:MR images were obtained in six women with severe pelvic ring pain after delivery, in 13 women after uncomplicated vaginal delivery, and in 11 healthy, nulliparous non-pregnant volunteers. Distances of the pubic gap, signal intensities of the pubic cartilage, and signal changes of the pelvic ring bones were determined and evaluated.Results: Both postpartum groups had significantly larger distances of the interpubic gap compared to the nulliparous group (P ϭ 0.0002). The mean signal intensity of cartilage of the symphysis pubis was significantly different on the T1-weighted and T2-weighted MR images in postpartum women compared to nulliparous women (P ϭ 0.001), indicating a higher water content of the pubic cartilage. 13 of all 19 postpartum women had bruises of parasymphyseal pubic bones. One pubic symphysis rupture and one sacral stress fracture were detected in two symptomatic women. Conclusion:MR imaging is a useful adjunct to clinical examination to identify patients with lesions of the pelvic ring postpartum. MRI of the pelvic ring of asymptomatic postpartum women can demonstrate signal changes of the pubic cartilage and small bruises of the pubic bones.

Prevalence of degenerative and spondyloarthritis-related magnetic resonance imaging findings in the spine and sacroiliac joints in patients with persistent low back pain

“…These results indicate that pregnancy-related physiological changes of the pelvic girdle may cause changes that can be visualised with MRI. Only few previous MRI studies have investigated pregnancy-related pathoanatomical changes at the SIJs [42,43], and further investigation of the cause of SIJ findings and their relationship to the female gender and pregnancy is needed before conclusions can be drawn.…”

Peripartale Veränderungen des Beckenringes:Wie sinnvoll ist die Magnetresonanztomografie?

“…Offensichtlich stehen diese Prozesse unter dem Einfluss des Schwangerschaftshormons Relaxin [26 -28]. MR-tomografische postpartale Veränderungen der Symphysis pubica wurden bis heute in zwei Arbeiten systematisch untersucht [31,32]. Kurzel et al [31] berichteten über zwei Patientinnen mit klinisch eindeutiger Symphysenruptur.…”

“…In die Studie von Wurdinger et al [32] wurden neben 13 asymptomatischen postpartalen Frauen auch sechs mit schweren Beckenschmerzen eingeschlossen, von denen eine die typischen klinischen Zeichen einer Symphysenruptur aufwies. Die ent- …”

Diastasis of symphysis pubis and labor: Systematic review

“…During labor, factors contributing to dilation of the birth canal might result in the total or partial breakage of the pubic symphysis, defined as a diastasis of 10 mm or more and associated symptomatology [1][2][3][4]. This pathology is called symphysis pubis diastasis (SPD), and epidemiological studies estimate a 2.8 percent incidence of SPD in women during and post labor [5].…”

“…Women often have pain and inflammation in the pubic symphysis, which may radiate into the lumbar and thigh areas, mainly in the medial regions. Moving, bearing a load, or raising a leg may often increase the symptoms and cause instability and incapacity while walking or standing [2][3][4][6][7].…”