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tissues in the body to relax. The relaxation is necessary so that during delivery, the female pelvis can stretch enough to allow birth. This stretching results in changes to the SIJs, making them overly mobile. Over a period of years, these changes can eventually lead to wear-and-tear arthritis. As would be expected, the more pregnancies a woman has, the higher her chances of SI joint problems. During the pregnancy, micro tears and small gas pockets can appear within the joint.
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up the spine. The SI joint, like all lower extremity joints, provides a "self-locking" mechanism (where the joint occupies or attains its most congruent position, also called the close pack position) that helps with stability during the push-off phase of walking. The joint locks (or rather becomes close packed) on one side as weight is transferred from one leg to the other, and through the pelvis the body weight is transmitted from the sacrum to the hip bone.
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ligaments include both long and short ligaments. The long dorsal sacroiliac joint ligaments run in an oblique vertical direction while the short (interosseous) runs perpendicular from just behind the articular surfaces of the sacrum to the ilium and functions to keep the sacroiliac joint from distracting or opening. The sacrotuberous and sacrospinous ligaments (also known as the extrinsic sacroiliac joint ligaments) limit the amount the sacrum flexes.
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295:, permits the pelvic joints to widen during the birthing process. The long SI ligaments may be palpated in thin persons for pain and compared from one side of the body to the other; however, the reliability and the validity of comparing ligaments for pain have currently not been shown. The interosseous ligaments are very short and run perpendicular from the iliac surface to the
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sacroiliac joint. When the provocative maneuvers reproduce pain along the typical area, it raises suspicion for sacroiliac joint dysfunction. However no single test is very reliable in diagnosing of sacroiliac joint dysfunction. Weakness, numbness, or the loss of a related reflex may indicate nervous system damage.
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The hormonal changes of menstruation, pregnancy, and lactation can affect the integrity of the ligament support around the SIJ, which is why women often find the days leading up to their period are when the pain is at its worst. During pregnancy, female hormones are released that allow the connective
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Like most lower extremity joints, one of the SI joints' functions is shock absorption (depending on the amount of available motion at the sacroiliac joint) for the spine, along with the job of torque conversion allowing the transverse rotations that take place in the lower extremity to be transmitted
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Women are considered more likely to suffer from sacroiliac pain than men, mostly because of structural and hormonal differences between the sexes, but so far no credible evidence exists that confirms this notion. Female anatomy often allows one fewer sacral segment to lock with the pelvis, and this
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The current gold standard for diagnosis of sacroiliac joint dysfunction emanating within the joint is sacroiliac joint injection confirmed under fluoroscopy or CT-guidance using a local anesthetic solution. The diagnosis is confirmed when the patient reports a significant change in relief from pain
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Given the inherent technical limitations of the visible and palpable signs from these sacroiliac joint mobility maneuvers, another broad category of clinical signs has been described called provocative maneuvers. These maneuvers are designed to reproduce or increase pain originating from within the
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Sacroiliac joint dysfunction is tested using provocative and nonprovocative maneuvers. Nonprovocative sacroiliac joint examination maneuvers would include Gillet Test, prone knee flexion test, supine long sitting test, standing flexion test, and seated flexion test. There is a lack of evidence that
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Aging changes the characteristics of the sacroiliac joint. The joint's surfaces are flat or planar in early life. Once walking ability is developed, the sacroiliac joint surfaces begin to develop distinct angular orientations and lose their planar or flat topography. They also develop an elevated
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Sacroiliac joints are paired C-shaped or L-shaped joints capable of a small amount of movement (2–18 degrees, which is debatable at this time) that are formed between the auricular surfaces of the sacrum and the ilium bones. However, most agree that there are only slight movements occur on these
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The posterior sacroiliac (SI) ligaments can be further divided into short (intrinsic) and long (extrinsic). The dorsal interosseous ligaments are very strong ligaments. They are often stronger than bone, such that the pelvis may actually fracture before the ligament tears. The dorsal sacroiliac
386:(also termed SI joint dysfunction; SIJD). Sacroiliac joint dysfunction generally refers to pain in the sacroiliac joint region that is caused by abnormal motion in the sacroiliac joint—either too much or too little motion. It typically results in inflammation of the SI joint, or sacroiliitis.
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and the diagnostic injection is performed on 2 separate visits. Published studies have used at least a 75 percent change in relief of pain before a response is considered positive and the sacroiliac joint deemed the source of pain.
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ridge along the iliac surface and a depression along the sacral surface. The ridge and corresponding depression, along with the very strong ligaments, increase the sacroiliac joints' stability and makes dislocations very rare. The
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Muscle imbalance, trauma (e.g., falling on the buttock) and hormonal changes can all lead to SIJ dysfunction. Sacroiliac joint pain may be felt anteriorly, however, care must be taken to differentiate this from hip joint pain.
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The anterior ligament is not much of a ligament at all and in most cases is just a slight thickening of the anterior joint capsule. The anterior ligament is thin and not as well defined as the posterior sacroiliac ligaments.
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joints, with only 3 degrees range of motion during flexion-extension, followed by 1.5 degrees axial rotation, and 0.8 degrees lateral bending. The joints are covered by two different kinds of
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Cibulka MT; Delitto A & Erhard RE (1992). "Pain patterns in patients with and without sacroiliac joint dysfunction". In
Vleeming A; Mooney V; Snijders CJ & Dorman T (eds.).
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Maigne, J. Y.; Aivaliklis, A; Pfefer, F (1996). "Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain".
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Anterior innominate tilt of one innominate bone while the opposite innominate bone tilts posteriorly on the sacrum (antagonistic innominate tilt) which occurs during gait
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The pain may become worse and sharp while doing activities such as standing up from a seated position or lifting the knee towards the chest during stair climbing.
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Sturesson, B; Uden, A; Vleeming, A (2000). "A radiostereometric analysis of movements of the sacroiliac joints during the standing hip flexion test".
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332:) Motions of the sacrum occur simultaneous with motion of the ilium so you must be careful in the description of these as isolated motions.
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377:. With sacroiliitis, the individual may experience pain in the low back, buttock or thigh, depending on the amount of inflammation.
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1172:"Value of quantitative radionuclide bone scanning in the diagnosis of sacroiliac joint syndrome in 32 patients with low back pain"
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and is supported in turn by an ilium on each side. The joint is strong, supporting the entire weight of the upper body. It is a
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Walker, Joan M. (1986). "Age-Related
Differences in the Human Sacroiliac Joint: A Histological Study; Implications for Therapy".
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Sturesson, B; Selvik, G; Udén, A (1989). "Movements of the sacroiliac joints. A roentgen stereophotogrammetric analysis".
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joints, one on the left and one on the right, that often match each other but are highly variable from person to person.
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Weisl, H. (1954). "The
Ligaments of the Sacro-Iliac Joint Examined with Particular Reference to Their Function".
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Solonen, K. A. (1957). "The sacroiliac joint in the light of anatomical, roentgenological and clinical studies".
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Low back pain and stiffness, often unilateral, that often increases with prolonged sitting or prolonged walking.
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Bogduk, Nicolai "Clinical and
Radiological Anatomy of the Lumbar Spine" Elsevier Health Sciences, 2022, p. 172.
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710:"Biomechanics of the Sacroiliac Joint: Anatomy, Function, Biomechanics, Sexual Dimorphism, and Causes of Pain"
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Pain is typically on one side or the other (unilateral PSIS pain), but the pain can occasionally be bilateral.
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with irregular elevations and depressions that produce interlocking of the two bones. The human body has two
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Posterior innominate tilt of both hip bones on the sacrum (where the left and right move together as a unit)
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Pain may occur during sexual intercourse; however, this is not specific to just sacroiliac joint problems.
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Schwarzer, A. C.; Aprill, C. N.; Bogduk, N (1995). "The sacroiliac joint in chronic low back pain".
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into the hip, groin, and occasionally down the leg, but rarely does the pain radiate below the knee.
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Interdisciplinary World Conference on Low Back Pain and its Relation to the Sacroiliac Joint
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Vleeming, A.; Schuenke, M. D.; Masi, A. T.; Carreiro, J. E.; Danneels, L.; Willard, F. H. (2012).
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Alderink, Gordon J. (1991). "The
Sacroiliac Joint: Review of Anatomy, Mechanics, and Function".
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Schunke, Gustave
Bernard (1938). "The anatomy and development of the sacro-iliac joint in man".
652:"The sacroiliac joint: An overview of its anatomy, function and potential clinical implications"
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Fortin, J. D.; Falco, F. J. (1997). "The Fortin finger test: An indicator of sacroiliac pain".
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The pain is often a mild to moderate ache around the dimple or posterior superior iliac spine (
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The following are signs and symptoms that may be associated with an SI joint (SIJ) problem:
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Dontigny, R. L. (1985). "Function and pathomechanics of the sacroiliac joint. A review".
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The ligaments of the sacroiliac joint loosen during pregnancy due to the hormone
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from the SIJ down into the buttock or back of the thigh, and rarely to the foot.
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When the pain of SIJ dysfunction is severe (which is infrequent), there can be
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refers to inflammation of one or both sacroiliac joints, and is one cause of
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Human female pelvis, anterior view, with sacroiliac joint within red ellipse.
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Mechanical SIJ dysfunction usually causes a dull unilateral low back pain.
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these sacroiliac joint mobility maneuvers detect motion abnormalities.
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Common mechanical problems of the sacroiliac joint are often called
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at the
College of Medicine at SUNY Upstate Medical University
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The ligaments of the sacroiliac joint include the following:
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The sacroiliac joints like all spinal joints (except the
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Sacroiliac joint. Deep dissection. Serial cross section.
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on the sacrum (where the left and right move as a unit)
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Maigne, J. Y.; Boulahdour, H.; Chatellier, G. (1998).
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Pages displaying wikidata descriptions as a fallback
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Sacroiliac joint of the male pelvis, posterior view
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216:Articulations of pelvis. Posterior view.
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714:International Journal of Spine Surgery
596: – Type of arthritis of the spine
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181:. In humans, the sacrum supports the
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484:adding citations to reliable sources
311:The motions of the sacroiliac joint
708:Kiapour, Ali (February 11, 2020).
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1550:posterior sacrococcygeal ligament
315:Anterior innominate tilt of both
1781:interosseous sacroiliac ligament
1545:anterior sacrococcygeal ligament
1265:Anatomy image: apmalefrontal4-18
1233:10.1097/00007632-199608150-00012
1141:10.1097/00007632-199501000-00007
1098:10.1097/00007632-200002010-00018
1055:10.1097/00007632-198902000-00004
798:Image-Guided Spine Interventions
668:10.1111/j.1469-7580.2012.01564.x
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259:Interosseous sacroiliac ligament
177:, which are connected by strong
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1350:posterior longitudinal ligament
1016:American Journal of Orthopedics
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1486:anterior atlantoaxial ligament
1345:anterior longitudinal ligament
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264:Posterior sacroiliac ligament
229:is usually 0.5 to 4 mm.
27:Joint of the pelvis and spine
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1455:Transverse ligament of atlas
794:"Sacroiliac Joint Injection"
571:Sacroiliac joint dysfunction
383:sacroiliac joint dysfunction
366:Sacroiliac joint dysfunction
356:Inflammation and dysfunction
254:Anterior sacroiliac ligament
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1451:Cruciate ligament of atlas
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843:10.2519/jospt.1986.7.6.325
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573: – medical condition
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1599:Intra-articular ligament
1391:intertransverse ligament
806:10.1007/0-387-21794-0_13
1753:inferior pubic ligament
1748:superior pubic ligament
1466:Apical ligament of dens
915:(inactive 2024-06-10).
78:articulatio sacroiliaca
1790:sacrotuberous ligament
1654:costoxiphoid ligaments
1176:European Spine Journal
594:Ankylosing spondylitis
558:anatomical terminology
269:Sacrotuberous ligament
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133:Anatomical terminology
1795:sacrospinous ligament
1386:interspinous ligament
1374:supraspinous ligament
1188:10.1007/s005860050083
771:10.1002/ar.1090720306
759:The Anatomical Record
351:Clinical significance
335:Sacral extension (or
274:Sacrospinous ligament
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1622:Lumbocostal ligament
901:Cells Tissues Organs
480:improve this section
1527:iliolumbar ligament
1413:intervertebral disc
995:. pp. 363–70.
962:10.1093/ptj/65.1.35
720:(Suppl 1): S3–S13.
585:Piriformis syndrome
328:Sacral flexion (or
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656:Journal of Anatomy
556:This article uses
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1728:
1726:
1723:
1722:
1720:
1718:
1717:pelvic girdle
1714:
1710:
1707:
1705:
1701:
1691:
1688:
1687:
1685:
1683:
1682:Costochondral
1679:
1673:
1670:
1669:
1667:
1665:
1664:Interchondral
1661:
1655:
1652:
1650:
1647:
1645:
1642:
1641:
1639:
1637:
1633:
1623:
1620:
1618:
1615:
1614:
1612:
1610:
1606:
1600:
1597:
1595:
1592:
1591:
1589:
1587:
1583:
1580:
1578:
1574:
1571:
1569:
1565:
1551:
1548:
1546:
1543:
1542:
1540:
1538:
1534:
1528:
1525:
1524:
1522:
1520:
1516:
1510:
1507:
1506:
1504:
1502:
1501:Zygapophysial
1498:
1492:
1489:
1487:
1484:
1483:
1480:
1476:
1475:
1472:
1469:
1467:
1464:
1462:
1461:Alar ligament
1459:
1456:
1452:
1448:
1447:
1445:
1443:
1442:Atlanto-axial
1439:
1436:
1434:
1430:
1423:
1420:
1418:
1414:
1411:
1410:
1408:
1406:
1402:
1392:
1389:
1387:
1384:
1380:
1377:
1376:
1375:
1372:
1370:
1367:
1366:
1364:
1362:
1357:
1351:
1348:
1346:
1343:
1342:
1340:
1338:
1333:
1330:
1328:
1324:
1321:
1319:
1315:
1311:
1307:
1303:
1296:
1291:
1289:
1284:
1282:
1277:
1276:
1273:
1266:
1263:
1262:
1258:
1250:
1246:
1242:
1238:
1234:
1230:
1226:
1222:
1215:
1212:
1207:
1203:
1198:
1193:
1189:
1185:
1182:(4): 328–31.
1181:
1177:
1173:
1166:
1163:
1158:
1154:
1150:
1146:
1142:
1138:
1134:
1130:
1123:
1120:
1115:
1111:
1107:
1103:
1099:
1095:
1091:
1087:
1080:
1077:
1072:
1068:
1064:
1060:
1056:
1052:
1048:
1044:
1037:
1034:
1029:
1025:
1022:(7): 477–80.
1021:
1017:
1010:
1007:
1002:
998:
994:
987:
984:
979:
975:
971:
967:
963:
959:
955:
951:
944:
941:
936:
930:
922:
918:
914:
910:
907:(3): 201–13.
906:
902:
895:
892:
887:
883:
879:
875:
871:
867:
860:
857:
852:
848:
844:
840:
837:(6): 325–34.
836:
832:
825:
822:
817:
815:0-387-40320-5
811:
807:
803:
799:
795:
788:
785:
780:
776:
772:
768:
765:(3): 313–31.
764:
760:
753:
750:
745:
741:
736:
731:
727:
726:10.14444/6077
723:
719:
715:
711:
704:
701:
695:
692:
687:
683:
678:
673:
669:
665:
662:(6): 537–67.
661:
657:
653:
646:
644:
642:
640:
636:
631:
627:
623:
619:
612:
610:
606:
600:
595:
592:
586:
583:
581:
578:
572:
569:
566:
563:
562:
559:
551:
542:
537:
532:
530:
526:
522:
510:
507:
499:
489:
485:
481:
475:
474:
470:
465:This section
463:
459:
454:
453:
447:
445:
441:
437:
430:
427:
424:
420:
417:
416:referred pain
413:
410:
407:
404:
400:
397:
396:
395:
389:
387:
385:
384:
378:
376:
375:low back pain
372:
367:
363:
355:
350:
348:
346:
345:atlanto-axial
338:
334:
331:
327:
324:
321:
318:
314:
313:
312:
309:
302:
300:
298:
294:
290:
285:
281:
275:
272:
270:
267:
265:
262:
260:
257:
255:
252:
251:
250:
244:
242:
240:
236:
230:
228:
224:
214:
206:
199:
197:
195:
191:
188:
184:
180:
176:
173:bones of the
172:
168:
164:
160:
156:
152:
140:
134:
130:
127:
124:
122:
118:
115:
112:
110:
106:
103:
100:
98:
94:
91:
88:
86:
82:
79:
76:
74:
70:
65:
60:
53:
48:
41:
36:
31:
19:
1785:
1762:
1690:no ligaments
1689:
1672:no ligaments
1671:
1636:Sternocostal
1509:no ligaments
1508:
1479:no ligaments
1478:
1224:
1220:
1214:
1179:
1175:
1165:
1132:
1128:
1122:
1092:(3): 364–8.
1089:
1085:
1079:
1049:(2): 162–5.
1046:
1042:
1036:
1019:
1015:
1009:
992:
986:
956:(1): 35–44.
953:
949:
943:
929:cite journal
904:
900:
894:
872:(2): 71–84.
869:
865:
859:
834:
830:
824:
797:
787:
762:
758:
752:
717:
713:
703:
694:
659:
655:
621:
617:
527:
523:
517:
502:
493:
478:Please help
466:
442:
438:
434:
421:Pain can be
393:
381:
379:
371:Sacroiliitis
369:
362:Sacroiliitis
342:
310:
306:
286:
282:
278:
248:
234:
231:
219:
193:
165:between the
158:
154:
150:
148:
102:A03.6.03.001
77:
1713:Syndesmoses
1586:Head of rib
1519:Lumbosacral
1327:Syndesmosis
1135:(1): 31–7.
227:joint space
190:plane joint
67:Identifiers
1814:Categories
1763:Sacroiliac
601:References
194:sacroiliac
18:Sacroiliac
1477:Lateral:
1405:Symphysis
1318:Vertebral
1306:ligaments
624:: 1–127.
467:does not
448:Pregnancy
405:) region.
317:hip bones
245:Ligaments
223:cartilage
200:Structure
179:ligaments
161:) is the
1449:Medial:
1249:25382636
1157:45511167
1114:33228238
1106:10703111
1071:10520615
1001:28057865
978:40558712
921:13137770
886:18796854
851:18802258
779:84682320
744:32123652
686:22994881
630:13478452
552:See also
423:referred
330:nutation
303:Function
187:synovial
169:and the
155:SI joint
1241:8875721
1206:9765042
1197:3611275
1149:7709277
1063:2922636
1028:9247654
970:3155567
735:7041664
677:3512279
488:removed
473:sources
289:relaxin
90:D012446
62:Details
1830:Sacrum
1825:Pelvis
1820:Joints
1704:Pelvis
1568:Thorax
1302:Joints
1247:
1239:
1204:
1194:
1155:
1147:
1112:
1104:
1069:
1061:
1026:
999:
976:
968:
919:
884:
849:
812:
777:
742:
732:
684:
674:
628:
297:sacrum
175:pelvis
167:sacrum
1310:torso
1245:S2CID
1221:Spine
1153:S2CID
1129:Spine
1110:S2CID
1086:Spine
1067:S2CID
1043:Spine
974:S2CID
775:S2CID
183:spine
171:ilium
163:joint
137:[
126:21440
73:Latin
1304:and
1237:PMID
1202:PMID
1145:PMID
1102:PMID
1059:PMID
1024:PMID
997:OCLC
966:PMID
935:link
917:PMID
882:PMID
847:PMID
810:ISBN
740:PMID
682:PMID
626:PMID
471:any
469:cite
403:PSIS
364:and
149:The
114:1861
97:TA98
85:MeSH
1715:of
1359:Of
1335:Of
1308:of
1229:doi
1192:PMC
1184:doi
1137:doi
1094:doi
1051:doi
958:doi
909:doi
874:doi
839:doi
802:doi
767:doi
730:PMC
722:doi
672:PMC
664:doi
660:221
482:by
159:SIJ
153:or
121:FMA
109:TA2
1816::
1788::
1243:.
1235:.
1225:21
1223:.
1200:.
1190:.
1178:.
1174:.
1151:.
1143:.
1133:20
1131:.
1108:.
1100:.
1090:25
1088:.
1065:.
1057:.
1047:14
1045:.
1020:26
1018:.
972:.
964:.
954:65
952:.
931:}}
927:{{
905:20
903:.
880:.
870:13
868:.
845:.
833:.
808:.
796:.
773:.
763:72
761:.
738:.
728:.
718:14
716:.
712:.
680:.
670:.
658:.
654:.
638:^
622:27
620:.
608:^
339:).
237:("
1457:)
1453:(
1424:)
1415:(
1294:e
1287:t
1280:v
1251:.
1231::
1208:.
1186::
1180:7
1159:.
1139::
1116:.
1096::
1073:.
1053::
1030:.
1003:.
980:.
960::
937:)
923:.
911::
888:.
876::
853:.
841::
835:7
818:.
804::
781:.
769::
746:.
724::
688:.
666::
632:.
560:.
509:)
503:(
498:)
494:(
490:.
476:.
157:(
141:]
20:)
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