Case 66

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Case 66

What’s the Diagnosis – Case 66 1


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Findings • Images demonstrate marked widening (diastasis) and moderate degenerative changes of the pubic symphysis as well as a marked widening and mild degenerative changes of the sacroiliac joints. What’s the Diagnosis – Case 66 5


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Diagnosis: Postpartum Pelvic Instability • The key piece of history withheld is that the patient had given birth 18 months ago with then persistent anterior and posterior pelvic pain. Chronic postpartum pelvic pain is an uncommon but potentially debilitating condition whose incidence and etiology are without a clear understanding. By in large most women respond well to conservative measures such as physcial therapy and anti-inflammatory medication. When persisting and recalcitrant to conservative measures, surgical intervention may be warranted. Depending on the site of the patient’s pain anterior or anterior/posterior fusion and/or fixation may be performed. What’s the Diagnosis – Case 66 9


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Resources • Am J Orthop (Belle Mead NJ). 2008 Dec;37(12):621-6. Management of persistent postpartum pelvic pain.Weil YA, Hierholzer C, Sama D, Wright C, Nousiainen MT, Kloen P, Helfet DL.SourceHadassah Hebrew University Hospital, Jerusalem, Israel. • http://radiopaedia.org/articles/parturition-induced-pelvic-instability What’s the Diagnosis – Case 66 13

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