| Bone Scan back |
| A bone scan is useful to see how the skeleton is reacting to any type of "stress,"
such as an injury, an infection, or inflammation from arthritis. This test involves injecting chemical "tracers"
into your blood stream. The tracers then show up on special spine X-rays.
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| Computed Tomography back |
| Radiofrequency lesioning is a surgical procedure that uses electrical pulses to
block nerve signals. It is a safe procedure in which a portion of nerve tissue is heated to cause a long-lasting
interruption in pain signals and reduce pain in that area. This will control pain and other related symptoms
travelling along a particular nerve. This procedure can be used to treat many kinds of specific and non-specific back pain.
This procedure is sometimes called radiofrequency ablation.
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| Magnetic Resonance Imaging (MRI) back |
| An MRI (magnetic resonance image) uses magnetic fields and a computer to take high-resolution
pictures of your bones and soft tissues, resulting in a cross-sectional image of your body. It can be used to help diagnose
torn muscles, ligaments and cartilage, hip or pelvic problems and other conditions. As with a CT scan, you lie on a table
that slides into the tube-shaped MRI scanner. The MRI creates a magnetic field around you, then pulses radio waves to
the area of your body to be pictured. The radio waves cause your tissues to resonate. Don't be alarmed; the machine
may be noisy.
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| Quantitative Computed Tomography
back |
| Quantitative computed tomography (QCT) is used to measure bone mineral density (BMD)
for osteoporosis. It is similar to a normal CT scan, but uses a computer software package that determines bone density
in the hip or spine. For those women who have been wheelchair bound for an extended amount of time a QCT can
determine what, if any, degree of bone density has been lost.
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| Radiographs (X-rays) back |
| X-rays (radiographs) are the most common and widely available diagnostic imaging
technique. Even if you just complain about a sprain in your wrist or ankle, your doctor will probably order
radiographs to make sure no bone is broken. X-rays are always used for fractures and joint dislocations,
and may also be recommended if your doctor suspects damage to a bone or joint from other conditions
such as arthritis, osteitis pubis, sacroiliitis and narrowing/widening of the symphysis pubis. They are used
to measure how well you can move a joint. For example, to test pelvic instability you will be asked to stand
on one leg and bend the other, then reverse it. If instability is present the pubic bones will appear uneven.
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| Obstetric Sonography (ultrasonography) back |
| Is the application of medical ultrasonography for obstetrics. Ultrasound is used to visualize the embryo or fetus
in its mother's uterus (womb). In some countries, routine pregnancy ultrasound scans are performed to detect developmental
defects before birth. Pelvic girdle pain can be detected by x ray, ultrasound or MRI scan. Medical professionals determine the size of the
gap as being that of 10 millimeters or above to indicate a diastasis of the symphysis pubis, while up to 9 mm is normal for pregnancy and
4-5mm normal for non-pregnancy
Pelvic Ultrasound
A pelvic ultrasound is a diagnostic tool used to image pelvic pathology and to image the uterus and ovaries or urinary bladder.
There are two methods of performing a pelvic ultrasound - externally or internally. The internal pelvic ultrasound is performed
transvaginally in women. An ultrasound can also be used to identify changes in the symphysis pubis.
Ultrasonography
Is a sound wave typically produced by creating short, strong
pulses of sound. The sound wave, is partially reflected from the
interface between different tissues and returns to the transducer.
The return sound wave vibrates the transducer's elements and turns
that vibration into electrical pulses that are sent from the probe
to ultrasound scanner where they are processed and transformed into
a digital image.
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| The Lasegue Test (Straight Leg Raise) back |
| This test is done with the patient supine and with the knee in extension. The examiner actively flexes
each thigh slowly while holding the other hand on the knee to prevent its flexion. The leg is lifted 90 degrees or until pain
prevents further motion. The final angle of flexion at which pain occurs, as well as the location and intensity of the pain is
noted by the examiner.
This test is considered positive when the straight leg cannot be raised to 90 degrees without pain.
This test is to evaluate load transfer through the pelvic girdle in the non-weight bearing position. While supine, the patient
is asked to lift one leg with the knee extended. Their ability to do so without bulging their abdomen, rotating or side bending
their trunk and pelvic girdle is observed and their effort to perform the task is noted. Force closure of the pelvic girdle is then
augmented by applying a gentle compression force through the pelvis. The active straight leg raise test is repeated and any
change in the motor pattern (ability to stabilize the pelvis in a neutral position) and in their effort is noted.
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| The Double Leg Raise Test back |
| This test is performed with the patient supine. The examiner straight leg raises each leg separately,
noting the angle where pain in produced. Then both legs are raised together, again noting the angle where pain is produced.
If the angle where pain occurs when both legs are lifted together is less than either leg when lifted separately, then this test
is considered positive indicating lumbosacral joint involvement.
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| Gillis' Test back |
| On this test the examiner places the base of the palm of one hand over the prone patient's
sacroiliac joint on the unaffected side, thus fixing the sacrum with the fingertips fanning over the affected sacroiliac joint.
With the other hand, the examiner lifts the thigh of the affected side putting the hip joint into extension. If this action
exacerbates the pain of the main complaint over the sacroiliac joint, the test is considered positive, indicating
Sacroiliac joint disease.
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| Nachlas' Test back |
| This test is performed with the patient in a prone position. Each foot is passively raised
from the table, maximally flexing the knee. The examiner also exerts downward pressure over the pelvis to prevent
buckling at the hips. The test is considered positive when the patient experiences pain in the sacroiliac region or
the lumbosacral region, and at times, along the nerves that run in front of these joints, indicating a lesion of those joints.
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| Pelvic Pain Provocation Test back |
| Patient supine, one hip joint flexed 90 degrees with knee bent. Practitioner stabilizes the
pelvis with one hand and then pushes with his other hand on the knee towards the hip joint. Usually triggers a familiar
pain in the posterior pelvis on the examined side only.
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| Pelvic Compression Test back |
| Patient lies on her side and has applied manual pressure to iliac crest.
Pain at sacroiliac joint or symphysis pubis suggests pelvic dysfunction.
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| Trendelenburg Test back |
| In this test, the patient stands on one foot, using a wall or chair for support. The
patient then lifts the opposite knee above waist level. The test is done bilaterally. This action will normally elevate
the gluteal fold and pelvis of the side being lifted above that of the standing leg side. When the gluteal fold and
pelvis on the side being lifted are lowered, the test is considered positive, indicating a gluteal (abductor) insufficiency
on the standing leg side.
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| Hip Adduction and Abduction back |
| Hip adduction
The examiner stands alongside the patient, the straight leg is held to slide slowly out to the side.
The examiner then applies pressure to inhibit the patient moving the leg towards the central axis of the body.
Hip Abduction
The examiner stands alongside the patient, the straight leg is held to slide slowly out to the side.
The examiner then applies pressure to inhibit the patient moving the leg away from the midline of the body.
The degree of how far the leg can be abducted and adducted and the amount of force the patient can
withstand during the applied pressure to inhibit the desired movement indicates the degree of pain and
weakness in the hip and pelvis. |
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