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Anatomy of pubic symphysis and sacroiliac joint (www.Am-medicine.com)
MOB TCD

Pubic Symphysis and
Sacroiliac Joint
Professor Emeritus Moira O’Brien
FRCPI, FFSEM, FFSEM (UK), FTCD
Trinity College
Dublin
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
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
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
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
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
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
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
“BMJ Publishing Group Limited (“BMJ Group”) 2012. All rights reserved.”

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Anatomy of pubic symphysis and sacroiliac joint (www.Am-medicine.com)

  • 2. MOB TCD Pubic Symphysis and Sacroiliac Joint Professor Emeritus Moira O’Brien FRCPI, FFSEM, FFSEM (UK), FTCD Trinity College Dublin
  • 3. 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
  • 4. 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
  • 5. 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
  • 6. 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
  • 7. 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
  • 8. 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
  • 9. 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
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Notes de l'éditeur

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