MOB TCD

Pubic Symphysis and
Sacroiliac Joint
Professor Emeritus Moira O’Brien
FRCPI, FFSEM, FFSEM (UK), FTCD
Trinity Coll...
MOB TCD

Pubic Symphysis
• Secondary cartilagenous
joint
• Articular surface of medial
aspect of body of pubis
• Covered w...
MOB TCD

Pubic Symphysis
• A cavity may develop in the
disc, but it is not lined with
synovial membrane
• The arcuate or i...
MOB TCD

Secondary Changes in Symphysis
• There is normally very little
movement at the pubic
symphysis, except during the...
MOB TCD

Sacroiliac Joint
• Modified synovial plane joint
• The auricular articular surfaces
of the sacrum and the Ilium
•...
MOB TCD

Sacroiliac Joint Accessory Ligaments
•
•
•
•

Sacrotuberous ligaments
Sacrospinous ligaments
Iliolumbar ligaments...
MOB TCD

Sacroiliac Joint
• Decreasing the torsional
stresses associated with
pelvic rotation
• Movement at the sacroiliac...
MOB TCD

Sacroiliac Joint
• Secondary changes may arise in
the joint due to anatomical
malalignments and biomechanical
fac...
“BMJ Publishing Group Limited (“BMJ Group”) 2012. All rights reserved.”
Anatomy of pubic symphysis and sacroiliac joint (www.Am-medicine.com)
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Anatomy of pubic symphysis and sacroiliac joint (www.Am-medicine.com)

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    1. 1. MOB TCD Pubic Symphysis and Sacroiliac Joint Professor Emeritus Moira O’Brien FRCPI, FFSEM, FFSEM (UK), FTCD Trinity College Dublin
    2. 2. MOB TCD Pubic Symphysis • Secondary cartilagenous joint • Articular surface of medial aspect of body of pubis • Covered with hyaline articular cartilage • Disc of fibrocartilage in between
    3. 3. MOB TCD Pubic Symphysis • A cavity may develop in the disc, but it is not lined with synovial membrane • The arcuate or inferior ligament is stronger than the superior pubic ligament
    4. 4. MOB TCD Secondary Changes in Symphysis • There is normally very little movement at the pubic symphysis, except during the latter months of pregnancy • Infection, e.g. Reiter’s syndrome • Loss of hip mobility, especially internal rotation Fricker, 1997
    5. 5. MOB TCD Sacroiliac Joint • Modified synovial plane joint • The auricular articular surfaces of the sacrum and the Ilium • The hyaline cartilage on the articular surfaces is rough • The capsule is attached just beyond the articular margin • The interosseous sacroiliac ligament is one of the strongest ligaments in the body and is posterior to the joint • This articulation is almost immobile
    6. 6. MOB TCD Sacroiliac Joint Accessory Ligaments • • • • Sacrotuberous ligaments Sacrospinous ligaments Iliolumbar ligaments Posterior superior iliac spine is middle of the joint posteriorly, it is superficial • During gait, the amount of accessory movement at the sacroiliac joint helps to protect the lumbar intervertebral discs
    7. 7. MOB TCD Sacroiliac Joint • Decreasing the torsional stresses associated with pelvic rotation • Movement at the sacroiliac joint also helps to decrease forward shearing at the L5/S1 junction during the hip extension phase of gait • More movement during pregnancy Tigney & Lindsay et al., quoted in DeMann, 1997
    8. 8. MOB TCD Sacroiliac Joint • Secondary changes may arise in the joint due to anatomical malalignments and biomechanical factors • Leg length discrepancies • Poor running technique • The arms swing across the front of the body, causing stress at the joint
    9. 9. “BMJ Publishing Group Limited (“BMJ Group”) 2012. All rights reserved.”

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