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CONDITION/DISORDER SYNONYMS
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Pubic symphysis pain
Pubic symphysis diastasis
Sacroiliac joint pain
Sacroiliac joint dysfunction
Symphysis pubis dysfunction
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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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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
M25.559 Pain in unspecified hip
S33.2 Dislocation of sacroiliac and sacrococcygeal joint
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PREFERRED PRACTICE PATTERN
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4D: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Connective Tissue Dysfunction
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PATIENT PRESENTATION
A 31-year-old female currently 23 weeks pregnant in her second pregnancy reports to her obstetrician/gynecologist that she is experiencing increasing pain in her “butt or her hip.” The symptoms have gradually become worse over the past few weeks. She feels sharp pain while rolling in bed, moving from sit to stand position, and when she starts to walk after sitting. She is having difficulty lifting and carrying her 2-year-old.
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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.1
Pain may radiate in the posterior thigh and can also occur in conjunction with/or separately in the symphysis.1
Endurance capacity for standing, walking, and sittingis diminished.
Generally arises in relation to pregnancy, trauma, orreactive arthritis.
Gradual or acute onset secondary to strain and impairment of load transfer at SIJ 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 performed on pregnant women unless pain associated with acute trauma such as motor vehicle accident
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