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Condition/Disorder Synonyms

  • Sacroiliac joint pain

  • Sacroiliac joint dysfunction

  • Pubic symphysis pain

  • Pubic symphysis diastasis

ICD-9-CM Codes

  • 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

ICD-10-CM Codes

  • 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

Preferred Practice Pattern

Key Features

Description

  • 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

Essentials of Diagnosis

  • 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

General Considerations

  • 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

Demographics

  • Commonly occurs in women during pregnancy

Clinical Findings

Signs and Symptoms

  • 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 ...

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