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Obturator nerve impingement caused by an osteophyte in the sacroiliac joint:A case report

World Journal of Clinical Cases 2021年第5期9卷 1168-1174页

作者： Man-Di Cai Hua-Feng Zhang Yong-Gang Fan Xian-Jun Su Lei Xia Department of Orthopedics The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450000Henan ProvinceChina Institute of Spinal Deformity The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450000Henan ProvinceChina

BACKGROUND Cases of obturator nerve impingement(ONI)caused by osteophytes resulting from bone hyperplasia on the sacroiliac articular surface have never been *** paper presents such a case in a patient in whom severe lower limb pain was caused by osteophyte compression of the sacroiliac joint on the obturator *** SUMMARY A 65-year-old Asian man presented with severe pain and numbness in his left lower limb,which became aggravated during walking and showed intermittent *** physical examination revealed that the muscle strength of the left lower limb had decreased and that the passive knee flexion test result was *** tomography(CT)and 3D reconstruction showed a large osteophyte located in the anterior lower part of the left sacroiliac *** results of electrophysiological examination showed peripheral neuropathy.A CT-guided obturator nerve block significantly reduced the severity of pain in this *** to the above findings,ONI caused by the osteophyte in the sacroiliac joint was *** patient underwent an operation to remove the bone spur and symptomatic *** therapy,the patient's pain and numbness were significantly *** last follow-up was performed 6 mo after the operation,and the patient recovered well without other complications,returned to work,and resumed his normal *** Osteophytes of the sacroiliac joint can cause ONI,which leads to symptoms including severe radiative pain in the lower limb in *** diagnosis and differentiation of this disease should attract the attention of *** excision of osteophytes should be considered when conservative treatment is not effective.

关键词： Obturator nerve impingement Osteophyte sacroiliac joint Case report

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Tuina for Leg Length Discrepancy and Lumbosacral Pain Due to sacroiliac joint Subluxation

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Journal of Acupuncture and Tuina Science 2014年第4期12卷 241-245页

作者： Zhang Zhao-xing Zhu Hong Wang Rui-hui Du Xu Qu Hong-yan Han Chou-ping Shaanxi University of Chinese Medicine The First Affiliated Hospital of Shaanxi University of Chinese Medicine

Objective： To observe theclinical effect of tuina reduction manipulation on leg length discrepancy and lumbosacral pain due to sacroiliac joint subluxation. Methods： A total of 60eligible cases were randomly allocated into an observation group and a control group, 30 in each group. Cases in the observation group were treated with conventional tuina plus reduction manipulation of sacroiliac joint subluxation; whereas cases in the control group were treated with conventional tuina plus acupuncture. The clinical effects were observed after 10 times of treatment. In addition, the relapse rates were observed 2 months after treatment. Results： The total effective rate in the observation group was 80.0%, versus 50.0% in the control group, showing a statistically significant difference （P＆lt;0.05）. The relapse rate of lumbosacral pain in the observation group was 12.5%, versus 66.7% in the control group, showing a statistically significant difference （P＆lt;0.01）. The relapse rate of leg length discrepancy in the observation group was 16.7%, versus 80.0% in the control group, showing a statistically significant difference （P＆lt;0.01）. Conclusion： Tuina reduction manipulation can obtain substantial therapeutic effect for leg length discrepancy and lumbosacral pain due to sacroiliac joint subluxation, coupled with a low relapse rate.

关键词： Tuina Massage Acupuncture Therapy Low Back Pain sacroiliac joint Subluxation Lumbosacral Region

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Clinical observation of needling gluteus medius muscle trigger point plus chiropractic for sacroiliac joint subluxation

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Journal of Acupuncture and Tuina Science 2018年第6期16卷 408-415页

作者： Zhou Wen-chun Wang Hong-nan Zhang Sheng Zhoushan Maternity and Infant Hospital Zhejiang Provincezhoushan 316000China

Objective:To observe the clinical effect of needling gluteus medius muscle trigger point (TrP) plus chiropractic for sacroiliac joint ***:A total of 124 cases conforming to the inclusion criteria of sacroiliac joint subluxation were classified by anterior subluxation and posterior subluxation,and randomized into a TrP group and a conventional group *** were 63 patients with anterior subluxation who were randomized into a TrP group of 32 cases (including 4 dropped out cases) and a conventional group of 31 cases (including 3 dropped out cases);and 61 patients with posterior subluxation who were randomized into a TrP group of 31 cases (including 3 dropped out cases) and a conventional group of 30 cases (including 3 dropped out cases).Patients in the TrP group received the treatment of needling gluteus medius muscle TrP plus chiropractic,while patients in the conventional group received conventional acupuncture treatment plus *** treatment was done twice a week for a succession of 8 ***,the pain visual analog scale (VAS),Oswestry disability index (ODI) and therapeutic efficacy were ***:After treatment,the total effective rate of TrP group with anterior subluxation was 96.9%,higher than 77.4% in the conventional group,the difference showed a statistical significance (Psacroiliac joint subluxation.

关键词： Acupuncture Therapy Tuina Massage Chiropractic Trigger Points joint Dislocations sacroiliac joint

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Value of dual-energy CT virtual noncalcium in the diagnosis of sacroiliac joint bone marrow edema

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Journal of Hainan Medical University 2021年第16期27卷 35-41页

作者： Dan-Dan Chen Rong-Hua Wang Zhi-Feng Wu Lin-Ning E Department of Imaging Medicine and Nuclear Medicine Shanxi Medical UniversityTaiyuan 030001China Department of Radiology Shanxi Bethune Hospital99 Longcheng StreetTaiyuanShanxi030032China

Objective:To explore the clinical value of dual energy CT(DECT)virtual noncalcium(VNCa)in the diagnosis of sacroiliac joint bone marrow edema(BME).Methods:A collection of 45 patients(21 males,24 females,and an average age of 34 years)who underwent MRI and DECT(Siemens Somatom definition force)examinations for the sacroiliac joints in our hospital from January 2019 to August *** the DECT scan,the bone marrow pseudo-color map was obtained after VNCa *** bone marrow pseudo-color map was evaluated by two *** MRI test results as the gold standard,the application value of DECT VNCa technology in the diagnosis of sacroiliac joint BME was ***:The positive predictive value(PPV),negative predictive value(NPV),sensitivity(Sen),specificity(Spe)and accuracy(Acc)of the qualitative diagnosis of iliac bone and sacral BME with DECT VNCa technology was:80.6%,85.2%,78.4%,86.8%,83.3%and 100%,64.9%,32.5%,100%,70.0%,*** area of edema displayed by quantitative measurement of DECT VNCa image is smaller than the area measured by MRI *** VNCa CT value(-71.66±72.97Hu)of the iliac edema area was higher than that of the non-edema area(-90.27±65.85Hu),and the VNCa CT value of the sacral edema area(-62.90±46.87Hu)was higher than that of the non-edema area(-101.08±134.02Hu),the best cut-off values(Cut-off values)for the quantitative diagnosis of iliac bone and sacral BME by VNCa are-66.40Hu and-50.60Hu,*** curve of the receiver operating characteristic(ROC)of the iliac bone and sacrum area under the cure(AUC)is 0.720 and 0.706 *** is a moderate negative correlation between the VNCa CT values of the ilium and sacrum in the edema area and the conventional CT ***:The DECT VNCa technique has certain effectiveness in the diagnosis of sacroiliac joint BME,and its effectiveness in the diagnosis of ilium BME is better than sacrum.

关键词： sacroiliac joint Bone marrow edema Dual-energy CT Virtual noncalcium(VNCa)

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Three-dimensional finite element analysis of the effects of ligaments on human sacroiliac joint and pelvis in two different positions

Three-dimensional finite element analysis of the effects of ...

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中国力学大会（CCTAM2019）

作者： YANG Jia-jing ZHAO Gai-ping XU Hai-fei WANG Fei School of Medical Instrument and Food Engineering University of Shanghai for Science and Technology Changhai Hospital of Shanghai

Objective: To present the effects of ligaments on the sacroiliac joint stability and human pelvis biomechanical characteristics in two different positions by using three-dimensional finite element models of the human pelvis. Methods: Based on the CT image data of human pelvis, three-dimensional finite element models of human pelvis in the sitting and standing positions was established, which include the bone(sacrum, ilium and coccyx) and the main six ligaments(sacroiliac, sacrospinous, sacrotuberous, inguinal, superior pubic and arcuate pubic ligaments). A force of 600 N was applied at the upper surface of the sacrum along the longitudinal axis of pelvis to analyze the stress and displacement distribution of the pelvic bone and sacroiliac joint(SIJ). Results: The simulation results demonstrate that the maximum stresses of sacrum and ilium on the SIJ contact surface are 5.63 MPa and 7.40 MPa in the standing position and 7.44 MPa and 7.95 MPa in the sitting position, respectively. The stresses of the ligament dysfunction group was higher than that of the health group, which increase by 22.6% and 35.7% in standing position and 25.2% and 43.6% in sitting position in sacrum and ilium. The maximum displacement locates on the upper surface of the sacrum, which was 0.13 mm and 1.04 mm in the standing and sitting positions. Ligaments dysfunction group increased 30.7% and 9.6% than health group in the standing and sitting positions. The integral displacement of pelvis bone in the sitting position was greater than that in the standing position. Conclusions: The location of stress concentration and displacement distribution of pelvic bone are closely resembled the previous research results in two different positions. The simulation results may provide beneficial information and theoretical models for clinical research of the pelvic fracture, joint movement and ligament functional injuries and so on.

关键词： pelvis ligaments sacroiliac joint different positions finite element model

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Role of diffusion-weighted imaging in early ankylosing spondylitis

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Chinese Medical Journal 2013年第4期126卷 668-673页

作者： PAN Chu HU Dao-yu ZHANG Wei LI Xiao-ming Department of Radiology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei 430030 China

Background With the advanced MRI techniques, pathologic features can be detected at an early stage and quantitatively evaluated, resulting in the advantages of early diagnosis and prompt treatment. This study aimed to determine the value of diffusion-weighted MR imaging （DWI） in detection of early ankylosing spondylitis （AS） and investigate the characteristic manifestations of AS on whole body DWl （WB-DWl）. Methods Twenty patients with the diagnosis of early AS, twenty patients with low back pain （LBP）, and twenty-five healthy volunteers were included in this study. The subchondral bone apparent diffusion coefficients （ADC） among these groups in the bilateral ilia and sacrum along the sacroiliac joints were compared. An independent sample t-test was utilized to analyze ADC value differences among groups. P-values less than 0.05 denoted statistical significance. The mean ADC values of focal DWl lesions in AS patients were also measured. Whole body diffusion-weighted imaging was performed in fifteen additional AS patients, and analyzed with MIP and MPR techniques in comparison to conventional MR images in order to evaluate the ability to detect AS lesions with whole body DWI. Results Mean ADC values in AS patients were （0.518±0.122）×10^-3 mm2/s in the ilium and （0.503＋0.168）x103 mm2/s in the sacrum. These were significantly greater than the values measured in the ilium and sacrum of LBP patients, （0.328±0.053）×10^-3 mm2/s in the ilium and （0.311±0.081）×10^-3 m2/s in the sacrum, and control group, （0.325±0.015）×10-3 mm2/s in the ilium and （0.318±0.011）×10^-3 mm2/s in the sacrum respectively. No statistically significant differences were found between LBP group and control group. The mean ADC value of focal DWI lesions in early AS patients was （0. 899±0.265）×10^-3 mm2/s, which was significantly higher than that of adjacent normal-appearance areas （（0.454±0.079）×10^-3 mm2/s）. WB-DWl detected abnormalities in the 15 additional AS patients both within the sacroiliac joints

关键词： diffusion weighted imaging ankylosing spondylitis sacroiliac joint

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