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  • Sacroiliac joint pain
  • Sacroiliac joint dysfunction
  • Pubic symphysis pain
  • Pubic symphysis diastasis

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  • 648.7 Bone and joint disorders of back pelvis and lower limbs of mother complicating pregnancy childbirth or the puerperium
  • 719.45 Pain in joint, pelvic region and thigh
  • 724.6 Disorders of sacrum
  • 846 Sprains and strains of sacroiliac region
  • 846.1 Sprain of sacroiliac ligament
  • 846.8 Sprain of other specified sites of sacroiliac region
  • 846.9 Sprain of unspecified site of sacroiliac region

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  • M25.559 Pain in unspecified hip
  • S33.2 Dislocation of sacroiliac and sacrococcygeal joint
  • CM 026.7 Subluxation of symphysis pubis in pregnancy, childbirth, and the puerperium
  • CM 026.71 Subluxation of the symphysis pubis in pregnancy
  • CM 026.711 Subluxation of the symphysis pubis in pregnancy, first trimester

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Description

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  • Pain experienced between the posterior iliac crest and the gluteal fold, particularly in the vicinity of the sacroiliac joints (SIJ) and/or the pubic symphysis1
  • Pain may radiate in the posterior thigh and can also occur in conjunction with/or separately in the symphysis1
  • Endurance capacity for standing, walking, and sitting is diminished
  • Generally arises in relation to pregnancy, trauma, or reactive arthritis
  • Gradual or acute onset secondary to strain and impairment of load transfer at sacroiliac joints or symphysis pubis

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Essentials of Diagnosis

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  • Diagnosis made by clinical examination including provocation tests and load transfer tests
  • Lumbar spine involvement and hip joint involvement must be ruled in or out
  • Reproduction of symptoms with clinical examination
  • No imaging is performed on pregnant women unless pain is associated with acute trauma such as motor vehicle accident

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General Considerations

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  • PGP in pregnancy is related to impaired functional stability of the pelvic girdle joints resulting in impairment of the transfer of load2
  • Pregnancy predisposes women to pelvic girdle pain because of reduced force closure of the pelvic girdle joints
  • May present with or without lumbar spine pain, radicular symptoms

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Demographics

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  • Commonly occurs in women during pregnancy

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Signs and Symptoms

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  • Pain experienced between the posterior iliac crest and the gluteal fold, particularly in the vicinity of the sacroiliac joints (SIJ) and/or the pubic symphysis and/or hips1
  • Pain can be unilateral, bilateral in the symphysis, or in all three joints3
  • Symphysis pubis pain may be extremely tender to the touch
  • Pain may radiate in the posterior thigh and/or groin/inner thigh
  • Pain can occur in conjunction with/or separately in the lumbar spine and pubic symphysis
  • Asymmetrical appearance of bony landmarks of the pelvis and malalignment of pelvic and/or back joints
  • Audible clicking sound coming from the pelvis

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Functional Implications

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  • Endurance capacity for standing, walking, and sitting is diminished1
  • Difficulty lifting legs and pain pulling ...

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