Single-Leg-Stance (Flamingo) Radiographs to Assess Pelvic Instability: How Much Motion Is Normal?

Garras, David N.; Carothers, Joshua T.; Olson, Steven A.

doi:10.2106/jbjs.g.00277

Cited by 86 publications

(53 citation statements)

References 12 publications

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“…After modifying the technique, Walheim measured mean displacements of 1 mm for males and 1.3 mm for females and maximum of 3.1 mm in one multiparous woman. A further study, using healthy volunteers as subjects, confirmed these previous findings by reporting symphysial movement in men of average 1.4 mm, in nulliparous woman 1.6 mm and in multiparous women 3.1 mm (Garras et al 2008).…”

Section: Specific Itemssupporting

confidence: 79%

Authors' response to the letter to the Editors by Professor M. T. Cibulka: a critical interpretation of sacroiliac joint movement studies

et al. 2013

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Section: Specific Itemssupporting

confidence: 79%

Authors' response to the letter to the Editors by Professor M. T. Cibulka: a critical interpretation of sacroiliac joint movement studies

et al. 2013

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“…12 Despite 1 patient opting to undergo revision surgery, 6 patients had a significant improvement in the mean visual analog scale pain score from 6.7 to 1.5 and the mean NonArthritic Hip Score from 50.2 to 84.7. The mean patient satisfaction rating was 8.3 points on a 10-point scale, there was no postoperative radiographic instability as measured by flamingo views, 13 and the only complication was transient scrotal swelling.…”

Section: Discussionmentioning

confidence: 94%

Endoscopic Pubic Symphysectomy for Athletic Osteitis Pubis

Matsuda

Sehgal

Matsuda³

2015

Arthroscopy Techniques

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Osteitis pubis is a common form of athletic pubalgia associated with femoroacetabular impingement. Endoscopic pubic symphysectomy was developed as a less invasive option than open surgical curettage for recalcitrant osteitis pubis. This technical note demonstrates the use of the anterior and suprapubic portals in the supine lithotomy position for endoscopic burr resection of pubic symphyseal fibrocartilage and hyaline endplates. Key steps include use of the suprapubic portal for burr resection of the posteroinferior symphysis and preservation of the posterior and arcuate ligaments. Endoscopic pubic symphysectomy is a minimally invasive bone-conserving surgery that retains stability and may be useful in the treatment of recalcitrant osteitis pubis or osteoarthritis. It nicely complements arthroscopic surgery for femoroacetabular impingement and may find broader application in this group of co-affected athletes.

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“…It may depict subchondral sclerosis, symphyseal lytic changes and widening or narrowing of the joint space, especially in the chronic phase of the disease [18,32,33] . Another proposed radiographic view, with major contribution to the pubic instability evaluation is the flamingo view in double and single leg stance positions [11,34] . This examination consists of an AP view of the pelvis with the patient standing on one leg.…”

Section: Radiographic Analysismentioning

confidence: 99%

“…A greater than 2 mm vertical pubic subluxation or greater than 7 mm of widening of the symphysis is considered to be pathognomic [1,35] . It has been assumed that up to 5 mm of physiologic motion can take place at the pubic symphysis in asymptomatic individuals [34] . It is worth mentioning that radiographic elements of OP do not represent symptomatic conditions in all the cases found and do not represent independent predictive factors of groin or hip pain [3,36] .…”

Section: Radiographic Analysismentioning

confidence: 99%

Osteitis pubis in elite athletes: Diagnostic and therapeutic approach

Angoules

2015

WJO

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Osteitis pubis (OP) is a debilitating overuse syndrome characterizing by pelvic pain and local tenderness over the pubic symphysis commonly encountered in athletes often involved in kicking, twisting and cutting activities in sports such as soccer and rugby and to a lesser degree distance running. It is a common source of groin pain in elite athletes attributable to pubis sympysis instability as the result of microtrauma caused by repetitive muscle strains on pubic bones. Diagnosis is based mainly on detailed sports history and a meticulous clinical examination, although occasionally is difficult to distinguish this nosological entity from other pathologies affecting the involved area which may occur concomitantly in the same patient. Radiologic examinations such as plain radiographs, magnetic resonance imaging and 3 phase bone isotope scanning may be helpful to differentiate from other clinical entities with similar clinical presentation. Most cases respond well to conservative treatment which includes several physical modalities and especially a progressive rehabilitation programmed individualized to each one of patients diagnosed with OP. Local injection therapies have been also been proposed as a non-operative therapeutic option for the efficient management of these patients. In refractory cases, surgical therapeutic strategies are warranted. These include several open or minimally invasive surgical interventions such as arthroscopic or open symphysis curettage, wedge or total resection of pubic sympysis, polypropylene mesh placement and pubic fusion. In this review a critical analysis of OP in elite athletes is performed with special focus on current concepts of diagnosis and management of this source of athletic groin pain.

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Single-Leg-Stance (Flamingo) Radiographs to Assess Pelvic Instability: How Much Motion Is Normal?

Abstract: This investigation suggests that up to 5 mm of physiologic motion can occur at the pubic symphysis in asymptomatic individuals, as demonstrated by alternating-single-leg-stance radiographs.

Cited by 86 publications

References 12 publications

Authors' response to the letter to the Editors by Professor M. T. Cibulka: a critical interpretation of sacroiliac joint movement studies

Authors' response to the letter to the Editors by Professor M. T. Cibulka: a critical interpretation of sacroiliac joint movement studies

Endoscopic Pubic Symphysectomy for Athletic Osteitis Pubis

Osteitis pubis in elite athletes: Diagnostic and therapeutic approach

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