Grgić Vjekoslav
Lijec Vjesn. 2005 Jan-Feb;127(1-2):30-5.
Sacroiliac joint dysfunction is one of the proved causes of sacroiliac joint syndrome. We are talking about the restricted mobility of sacrum opposite to ilium the type of "reversible blockage of movement". Main characteristics of dysfunction are as follows: restricted "joint play", referred pain, normal radiological finding, normal lab results and disappearance of clinical symptoms after deblocking of articular bodies. Pain from a blocked joint can be referred to lower back, buttocks, hip, groin, thigh, calf and lower part of abdomen. Dispersion of painful regions is a consequence of a complex and variable innervation of articular capsule. Blocked position of articular bodies and protracted tension of articular capsule causes a stimulus of nociceptors by which a capsule is protected. Nociceptive activity is manifested with referred pains in innervational region of stimulated sensitive nerves. In the article, besides the clinical manifestations, there is described a diagnostics and manual therapy of dysfunction. Springing tests by means of which a passive mobility ("joint play") is being tested, are most valuable in dysfunction diagnostics. Manual therapy (mobilization/manipulation) is indicated and efficacious with the patients suffering from dysfunction.
骶髂关节功能障碍是已被证实的骶髂关节综合征的病因之一。我们所说的是骶骨相对于髂骨活动受限的“可逆性运动阻滞”类型。功能障碍的主要特征如下:“关节活动”受限、牵涉痛、放射学检查结果正常、实验室检查结果正常以及关节体解除阻滞后临床症状消失。关节阻滞引起的疼痛可牵涉至下背部、臀部、髋部、腹股沟、大腿、小腿和腹部下部。疼痛区域的扩散是关节囊复杂多变的神经支配的结果。关节体的阻滞位置和关节囊的长期紧张会刺激伤害感受器,而关节囊正是通过伤害感受器得到保护。伤害感受活动表现为受刺激的敏感神经支配区域的牵涉痛。在本文中,除了临床表现外,还描述了功能障碍的诊断和手法治疗。通过弹跳试验来测试被动活动度(“关节活动”),这在功能障碍的诊断中最有价值。手法治疗(松动术/整复术)适用于患有功能障碍的患者且疗效显著。