Colour Doppler Imaging: New Applications in Musculoskeletal System Pathology

In the departments of Rehabilitation, Biomedical Physics and Technology, and Anatomy research and clinics of the musculoskeletal system fonn the centre of attention. In this field pathologies related to low back pain and hand and wrist are under investigation. In both areas some quantitative assessments for diagnosis, treatment and follow-up can not be done with existing routine techniques. For normal examination procedures many means are available. Examples of clinical examinations are Laseque; imaging techniques, e.g. X-rays, CT and MRI; functional laboratory techniques e.g. dynamometry and EMG, and special facilities like bone traction. In the study on low back pain special interest raised for the mechanical properties oftlIe pelvic joints, in particular the sacroiliac (SI) joints. For the assessment of SI joint stifthess no instrumented method was available. In the study 011 the hand and wrist pathology no method was available to measure non-invasively the function of the tendons. While searching for solutions we discovered that Colour Doppler Imaging (CDI) opened flew possibilities in the research of the musculoskeletal system in general, and for our research interests in particular. In the following paragraphs a general introduction is given on the existing routine use of CD!. Further, application on the assessment of SI joint stiffness, and hand and wrist pathologies is introduced in separate sectors which give a brief overview of the chapters of this thesis. The general aim of this study is to extend the application of CDI in the field of the musculoskeletal system

Pelvic pain during pregnancy is associated with asymmetric laxity of the sacroiliac joints.

Contains fulltext : 87147.pdf (publisher's version ) (Closed access)OBJECTIVE: The aim of this study was to investigate the association between pregnancy-related pelvic pain (PRPP) and sacroiliac joint (SIJ) laxity. METHODS: A cross-sectional analysis was performed in a group of 163 women, 73 with moderate or severe (PRPP+) and 90 with no or mild (PRPP-) PRPP at 36 weeks of pregnancy. SIJ laxity was measured by means of Doppler imaging of vibrations in threshold units (TU). Pain, clinical signs and disability were assessed with visual analog scale (VAS), posterior pelvic pain provocation (PPPP) test, active straight leg raise (ASLR) test, and Quebec back pain disability scale (QBPDS), respectively. RESULTS: Mean SIJ laxity in the PRPP+ group was not significantly different from the PRPP- group (3.0 versus 3.4 TU). The mean left-right difference, however, was significantly higher in the PRPP+ group (2.2 TU) than in the PRPP- group (0.9 TU). In the PRPP- group, only 4% had asymmetric laxity of the SIJs in contrast to 37% of the PRPP+ group. Between the PRPP+ subjects with asymmetric and symmetric laxity of the SIJs significant differences were found with respect to mean VAS for pain (7.9 versus 7.0), positive PPPP test (59% versus 35%), positive ASLR test (85 versus 41%) and mean QBPDS score (61 versus 50). CONCLUSIONS: Increased SIJ laxity is not associated with PRPP. In fact, pregnant women with moderate or severe pelvic pain have the same laxity in the SIJs as pregnant women with no or mild pain. However, a clear relation between asymmetric laxity of the SIJs and PRPP is found.1 november 200

Pelvic pain during pregnancy is associated with asymmetric laxity of the sacroiliac joints

PubMedID: 11703199Objective. The aim of this study was to investigate the association between pregnancy-related pelvic pain (PRPP) and sacroiliac joint (SIJ) laxity. Methods. A cross-sectional analysis was performed in a group of 163 women, 73 with moderate or severe (PRPP+) and 90 with no or mild (PRPP-) PRPP at 36 weeks of pregnancy. SIJ laxity was measured by means of Doppler imaging of vibrations in threshold units (TU). Pain, clinical signs and disability were assessed with visual analog scale (VAS), posterior pelvic pain provocation (PPPP) test, active straight leg raise (ASLR) test, and Quebec back pain disability scale (QBPDS), respectively. Results. Mean SIJ laxity in the PRPP+ group was not significantly different from the PRPP-group (3.0 versus 3.4 TU). The mean left-right difference, however, was significantly higher in the PRPP+ group (2.2 TU) than in the PRPP- group (0.9 TU). In the PRPP- group, only 4% had asymmetric laxity of the SIJs in contrast to 37% of the PRPP+ group. Between the PRPP+ subjects with asymmetric and symmetric laxity of the SIJs significant differences were found with respect to mean VAS for pain (7.9 versus 7.0), positive PPPP test (59% versus 35%), positive ASLR test (85 versus 41%) and mean QBPDS score (61 versus 50). Conclusions. Increased SIJ laxity is not associated with PRPP. In fact, pregnant women with moderate or severe pelvic pain have the same laxity in the SIJs as pregnant women with no or mild pain. However, a clear relation between asymmetric laxity of the SIJs and PRPP is found

The prognostic value of asymmetric laxity of the sacroiliac joints in pregnancy-related pelvic pain.

Contains fulltext : 87154.pdf (publisher's version ) (Closed access)STUDY DESIGN: Prospective cohort study. OBJECTIVE: To determine the prognostic value of asymmetric laxity of the sacroiliac joints during pregnancy on pregnancy-related pelvic pain postpartum. SUMMARY OF BACKGROUND DATA: In a previous study, we observed a significant relation between asymmetric laxity of the sacroiliac joints and moderate to severe pregnancy-related pelvic pain during pregnancy. METHODS: A group of 123 women were prospectively questioned and examined, and sacroiliac joint laxity was measured by means of Doppler imaging of vibrations at 36 weeks' gestation and at 8 weeks' postpartum. A left to right difference in sacroiliac joint laxity >or=3 threshold units was considered to indicate asymmetric laxity of the sacroiliac joints. RESULTS: In subjects with moderate to severe pregnancy-related pelvic pain during pregnancy, sacroiliac joint asymmetric laxity was predictive of moderate to severe pregnancy-related pelvic pain persisting into the postpartum period in 77% of the subjects. The sensitivity, specificity, and positive predictive value of sacroiliac joint asymmetric laxity during pregnancy for pregnancy-related pelvic pain persisting postpartum were 65%, 83%, and 77%, respectively. Subjects with moderate to severe pregnancy-related pelvic pain and asymmetric laxity of the sacroiliac joints during pregnancy have a threefold higher risk of moderate to severe pregnancy-related pelvic pain postpartum than subjects with symmetric laxity. CONCLUSION: These data indicate that in women with moderate to severe complaints of pelvic pain during pregnancy, sacroiliac joint asymmetric laxity measured during pregnancy is predictive of the persistence of moderate to severe pregnancy-related pelvic pain into the postpartum period