Diastasis symphysis pubis
Encyclopedia
Diastasis symphysis pubis is the separation of normally joined pubic bones, as in the dislocation of the bones, without a fracture.
by radiologic
studies such as x-ray
, MRI, CT scan or bone scan
. Manual testing by a Healthcare Professional can also be used. The patient is placed in various positions and pressure is applied in such a way that it provokes pain and maybe movement in the pubis.
, hormonal
influences cause relaxation of the connecting ligaments and the bones separate up to 9 mm. To demonstrate instability of the joint the patient is required to stand in the "flamingo" position, (standing with weight on one leg and the other bent). A vertical displacement of more than 1 cm is an indicator of symphysis pubis instability. A displacement of more than 2 cm usually indicates involvement of the sacroiliac joints.
In former times obstructed childbirth was sometimes treated by cutting the pubic symphysis (symphysiotomy
), letting the pelvis halves hinge outwards at the sacroiliac joints.
Diagnosis
This abnormally wide gap can be diagnosedDiagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
by radiologic
Radiology
Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiologists use an array of imaging technologies to diagnose or treat diseases...
studies such as x-ray
X-ray
X-radiation is a form of electromagnetic radiation. X-rays have a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz and energies in the range 120 eV to 120 keV. They are shorter in wavelength than UV rays and longer than gamma...
, MRI, CT scan or bone scan
Bone scan
A bone scan or bone scintigraphy is a nuclear scanning test to find certain abnormalities in bone which are triggering the bone's attempts to heal. It is primarily used to help diagnose a number of conditions relating to bones, including: cancer of the bone or cancers that have spread to the bone,...
. Manual testing by a Healthcare Professional can also be used. The patient is placed in various positions and pressure is applied in such a way that it provokes pain and maybe movement in the pubis.
X-ray
An X-ray film will show a marked gap between the pubic bones, normally there is a 4–5 mm gap but in pregnancyPregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
, hormonal
Hormone
A hormone is a chemical released by a cell or a gland in one part of the body that sends out messages that affect cells in other parts of the organism. Only a small amount of hormone is required to alter cell metabolism. In essence, it is a chemical messenger that transports a signal from one...
influences cause relaxation of the connecting ligaments and the bones separate up to 9 mm. To demonstrate instability of the joint the patient is required to stand in the "flamingo" position, (standing with weight on one leg and the other bent). A vertical displacement of more than 1 cm is an indicator of symphysis pubis instability. A displacement of more than 2 cm usually indicates involvement of the sacroiliac joints.
CT scan and MRI
Both diagnostic machines can produce detailed cross sections of the pelvic area. Images will show degrees soft tissue injury, inflammation of the subchondral region and the bone marrow and any abnormal posturing of the pelvic joints.External forces
External forces such as falling from a horse or a car accident can result in this type of injury to the symphysis pubis.In former times obstructed childbirth was sometimes treated by cutting the pubic symphysis (symphysiotomy
Symphysiotomy
Symphysiotomy is a surgical procedure in which the cartilage of the pubic symphysis is divided to widen the pelvis allowing childbirth when there is a mechanical problem.- Introduction :...
), letting the pelvis halves hinge outwards at the sacroiliac joints.
Other conditions
- In extroversion of the bladder there is a gap between the pubes, which are joined by a strong interpubic ligament.