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Psoriatic arthritis (PsA) is a long-term inflammatory arthritis that occurs in people affected by the autoimmune disease psoriasis. The classic feature of psoriatic arthritis is swelling of entire fingers and toes with a sausage-like appearance. This often happens in association with changes to the nails such as small depressions in the nail (pitting), thickening of the nails, and detachment of the nail from the nailbed. Skin changes consistent with psoriasis frequently occur before the onset of psoriatic arthritis but psoriatic arthritis can precede the rash in 15% of affected individuals. It is classified as a type of seronegative spondyloarthropathy.
The sacroiliac joint or SI joint (SIJ) is the joint between the sacrum and the ilium bones of the pelvis, which are connected by strong ligaments. In humans, the sacrum supports the spine and is supported in turn by an ilium on each side. The joint is strong, supporting the entire weight of the upper body. It is a synovial plane joint with irregular elevations and depressions that produce interlocking of the two bones. The human body has two sacroiliac joints, one on the left and one on the right, that often match each other but are highly variable from person to person.
The piriformis muscle is a flat, pyramidally-shaped muscle in the gluteal region of the lower limbs. It is one of the six muscles in the lateral rotator group.
Piriformis syndrome is a condition which is believed to result from compression of the sciatic nerve by the piriformis muscle. The largest and most bulky nerve in the human body is the sciatic nerve. Starting at its origin it is 2 cm wide and 0.5 cm thick. The sciatic nerve forms the roots of L4-S3 segments of the lumbosacral plexus. The nerve will pass inferiorly to the piriformis muscle, in the direction of the lower limb where it divides into common tibial and fibular nerves. Symptoms may include pain and numbness in the buttocks and down the leg. Often symptoms are worsened with sitting or running.
Sacroiliitis is inflammation within the sacroiliac joint. It is a feature of spondyloarthropathies, such as axial spondyloarthritis, psoriatic arthritis, reactive arthritis or arthritis related to inflammatory bowel diseases, including ulcerative colitis or Crohn's disease. It is also the most common presentation of arthritis from brucellosis.
Gaenslen's test, also known as Gaenslen's maneuver, is a medical test used to detect musculoskeletal abnormalities and primary-chronic inflammation of the lumbar vertebrae and sacroiliac joint. This test is often used to test for spondyloarthritis, sciatica, or other forms of rheumatism, and is often performed during checkup visits in patients who have been diagnosed with one of the former disorders. It is named after Frederick Julius Gaenslen, the orthopedic surgeon who invented the test. This test is often performed alongside Patrick's test and Yeoman's test.
The knee examination, in medicine and physiotherapy, is performed as part of a physical examination, or when a patient presents with knee pain or a history that suggests a pathology of the knee joint.
In medicine, physiotherapy, chiropractic, and osteopathy the hip examination, or hip exam, is undertaken when a patient has a complaint of hip pain and/or signs and/or symptoms suggestive of hip joint pathology. It is a physical examination maneuver.
The interosseous sacroiliac ligament, also known as the axial interosseous ligament, is a ligament of the sacroiliac joint that lies deep to the posterior ligament. It connects the tuberosities of the sacrum and the ilium of the pelvis.
A pelvic fracture is a break of the bony structure of the pelvis. This includes any break of the sacrum, hip bones, or tailbone. Symptoms include pain, particularly with movement. Complications may include internal bleeding, injury to the bladder, or vaginal trauma.
The facet joints are a set of synovial, plane joints between the articular processes of two adjacent vertebrae. There are two facet joints in each spinal motion segment and each facet joint is innervated by the recurrent meningeal nerves.
Greater trochanteric pain syndrome (GTPS), a form of bursitis, is inflammation of the trochanteric bursa, a part of the hip.
The Ortolani test is part of the physical examination for developmental dysplasia of the hip, along with the Barlow maneuver. Specifically, the Ortolani test is positive when a posterior dislocation of the hip is reducible with this maneuver. This is part of the standard infant exam performed preferably in early infancy.The Ortolani test is named after Marino Ortolani, who developed it in 1937.
Pubic symphysis diastasis is the separation of normally joined pubic bones, as in the dislocation of the bones, without a fracture that measures radiologically more than 10 mm. Separation of the symphysis pubis is a rare pathology associated with childbirth and has an incidence of 1 in 300 to 1 in 30,000 births. It is usually noticed after delivery but can be observed up to six months postpartum. Risk factors associated with this injury include cephalopelvic disproportion, rapid second stage of labor, epidural anesthesia, severe abduction of the thighs during delivery, or previous trauma to the pelvis. Common signs and symptoms include symphyseal pain aggravated by weight-bearing and walking, a waddling gait, pubic tenderness, and a palpable interpubic gap. Treatment for pubic symphysis diastasis is largely conservative, with treatment modalities including pelvic bracing, bed rest, analgesia, physical therapy, and in some severe cases, surgery.
Pelvic girdle pain can be described as a pregnancy discomfort for some women and a severe disability for others. PGP can cause pain, instability and limitation of mobility and functioning in any of the three pelvic joints. PGP has a long history of recognition, mentioned by Hippocrates and later described in medical literature by Snelling.
The affection appears to consist of relaxation of the pelvic articulations, becoming apparent suddenly after parturition or gradually during pregnancy and permitting a degree of mobility of the pelvic bones which effectively hinders locomotion and gives rise to the most peculiar and alarming sensations.
Yeoman's test is a physical exam performed to determine if a person has sacroiliitis. With the subject prone, the test is performed by rotating the ilium with one hand and extending the hip while the knee is flexed. Pain over the ipsilateral posterior sacroiliac joint area is indicative of sacroiliitis.
The term sacroiliac joint dysfunction refers to abnormal motion in the sacroiliac joint, either too much motion or too little motion, that causes pain in this region.
The pelvis is the lower part of the trunk, between the abdomen and the thighs, together with its embedded skeleton.
The sacroiliac joint is a paired joint in the pelvis that lies between the sacrum and an ilium. Due to its location in the lower back, a dysfunctional sacroiliac joint may cause lower back and/or leg pain. The resulting leg pain can be severe, resembling sciatica or a slipped disc. While nonsurgical treatments are effective for some, others have found that surgery for the dysfunctional sacroiliac joint is the only method to relieve pain.
Pain in the hip is the experience of pain in the muscles or joints in the hip/ pelvic region, a condition commonly arising from any of a number of factors. Sometimes it is closely associated with lower back pain.
References
- ↑ Görtz, Simon; Fricka, Kevin B.; Bugbee, William D. (2015). "The hip". Rheumatology. p. 626. doi: 10.1016/B978-0-323-09138-1.00076-0 . ISBN 9780323091381.
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