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

Abstract

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.

Reflexões sobre as disfunções sacroilíaca e sexual

“…Os movimentos das articulações sacrilíacas e a sínfise púbica não possuem músculos que controlem diretamente os seus movimentos, eles são influenciados pela ação de músculos que movem a coluna lombar e os quadris, muitos dos quais se fixam no sacro e na pelve (MAGEE, 2005), exemplos são os músculos obturadores internos, piriforme, adutores, glúteos e abdominais, que são adjacentes aos MAP, desta forma, alterações em quaisquer um desses músculos podem ocasionar disfunções pélvicas devido ao desequilíbrio muscular, tensão e encurtamento dessas cadeias musculares ligadas à pelve ( YENG et al, 2001;CALAIS-GERMAIN, 2005;MIRANDA;SCHOR;GIRÃO, 2009).…”

“…Além disso, as raízes L4 a S4 são responsáveis pela inervação da articulação sacroílíaca e justificam a ampla distribuição da dor referida nas regiões sacral, pubiana e perineal, face posterior da coxa e da perna, face plantar do pé, além do espasmo reflexo do piriforme e músculos glúteos ( YENG et al, 2001).Há sobreposição nervosa entre a inervação das articulações sacroilíacas e de todos os órgãos pélvicos, incluindo seu assoalho, via nervo pudendo, raízes S2, S3 e S4 (COSTA, 2013).…”

A Scientific Perspective of Neijin (Internal Strength)

“…The vertebral column ends at the sacrum which sits on the pelvic (iliac) base at a "plane" joint, called the sacral-iliac joint (SIJ). The SIJ forms the hub of the transfer of forces between the upper and lower body via the three levers, the spine and the legs through the pelvic platform [2].…”

“…The vertebral column ends at the sacrum which sits on the pelvic (iliac) base at a "plane" joint, called the sacral-iliac joint (SIJ). The SIJ forms the hub of the transfer of forces between the upper and lower body via the three levers, the spine and the legs through the pelvic platform [2].The hub function of the SIJ has actually been described in the Taiji classics as well:If the body cannot maneuver to take timely advantage (de ji de shi 得机得势), then the problem is at the waist and legs.Strength is released from the spine, supported by the legs, stepping with body following in accord. …”

Frequency of pelvic asymmetry among medical students of Karachi

“…It maintains a connection to the arms, legs and head through muscular, ligamentous and fascial attachments 1 . According to a study human pelvis is unique in shape and pelvis is a complicated bone due to its landmark but functionally it is very important to bone and aids in mobility of the human body 2 .…”