| Revista: | Acta ortopedica brasileira |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000269456 |
| ISSN: | 1413-7852 |
| Autors: | Ribeiro, Sady1 Schmidt, Andre Prato2 Wurff, Peter van der3 |
| Institucions: | 1University of Texas, Department of Neurobiology, Houston, Texas. Estados Unidos de América 2Universidade de Sao Paulo, Faculdade de Medicina, Sao Paulo. Brasil 3Military Rehabilitation Centre Doorn, Doorn, Utrecht. Holanda |
| Any: | 2003 |
| Període: | Abr-Jun |
| Volum: | 11 |
| Número: | 2 |
| Paginació: | 118-125 |
| País: | Brasil |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico, descriptivo |
| Resumen en inglés | The sacroiliac joint, due to its anatomic aspect, is a very particular joint. It can be affected by several pathologies. Seronegative spondyloarthropaties are classical examples of these disorders. Sacroiliac Dysfunction seems to be a biomechanical dysfunction of this joint and could be a cause of chronic back pain. History and physical exam, due to poor specificity, might not be enough to make this diagnosis. Imaging studies are not very helpful either Anesthetics block, guided by fluoroscopy, CT, or MRI is considered the "gold standard" test, which proves that pain originates from the joint. When conservative treatment fails, invasive therapeutic modalities can be used, but their efficacy has not yet been proven. Arthrodesis should be reserved for the very disabling cases that did not respond to the less aggressive approaches. Opioids may be the last hope for some patients Disorders of the sacroiliac joint sometimes can be a challenge regarding diagnosis and treatment(8). Since the joint is deeply located, proper assessment is difficult(4). Its anatomy is complex and unique with a syndesmotic superior compartment and synovial inferior one(4). The iliac bone presents a thin fibrocartilagionous cartilage and the sacral bone is covered by a thicker hyaline cartilage, which makes the iliac side more vulnerable to any pathology that might affect the joint(6,9). The joint surfaces remain flat until the twenties, but with time there is an increase in the number and size of elevations and depressions of the articular surfaces(5,21); enhancing friction and stability of the joint(15). Ligamentous structures, which are the strongest of the body, localize anteriorly and posteriorly, contributing to the stability of the joint(7). Capsulated and uncapsulated nerve endings are present in the joint and surrounding ligaments, making the sacroiliac joint a possible source of pain(54) |
| Disciplines | Medicina |
| Paraules clau: | Terapéutica y rehabilitación, Traumatología y ortopedia, Articulación sacroiliaca, Espondiloartropatías, Artrodesis, Dolor crónico, Narcóticos |
| Keyword: | Medicine, Therapeutics and rehabilitation, Traumatology and orthopedics, Sacroiliac joint, Spondyloarthropathies, Arthrodesis, Chronic pain, Narcotics |
| Text complet: | Texto completo (Ver HTML) |
