#Badgley Book Sign (#BBS) best way to diagnose SIJ Subluxation Chronic Pain Disorder Syndrome (my monicker). Way to prove disorder: After shown in clinic, person sent for cross-table lateral X-ray of pelvis before & after 1” ischial bolster placed separately under each buttock...
Guideon bible works well as standardized bolster. Person sits on X-ray table w. legs horizontal. Measure of subluxation is shift of femur acetabulum, & this can be measured to mm. This shift occurs as hemipelvis rotates about virtual transverse-body axis about mid-SIJ region...
Rotation of hemi-pelvis (Ilium bone)around sacroiliac joint (SIJ) axis is only few degrees & unable to be seen via fluoroscopy; I tried. The cause of rotation is lax/injured SIJ ligaments. The secret of interpretation of data is to know which ligament system is injured...
In my last Tweet Thread, I discussed how to recognize which sacroiliac joint is injured. In this thread I discuss how to clinically locate ligament injury. There are, simplistically, two ligament systems that tether Ilium to Sacrum: Iliolumbar & Sacrotuberous ...
ILIOLUMBAR: ligament tethering Ilium to lower lumbar region. This ligament system prevents abnormal counter-nutation of sacroiliac joint; manifest as upper leg shortening, as hemi-pelvis rotates. Ligament oft injured lifting-torsion injuries; amongst other mechanical injuries...
SACROTUBEROUS: ligament tethers Ischial prominence (butt bone) to lower Sacrum & prevents nutation of SIJ; manifest as upper leg lengthening as hemi-pelvis rotates. Ligament oft injured in falls onto one buttock/leg from height & in MVA, where one leg is predominantly braced...
WAY TO EXAMINE LIGAMENTS: patient stands & examiner marches fingers around pelvic brim to junction of iliac crest & lumbar spine & pokes in deeply. An injured Iliolumbar ligament arouses pain. Deep palpation into medial Ischial prominence arouses Sacrotuberous pain.
The #Badgley Book Sign can document these ligament injuries via X-ray imaging of nutation & counter-nutation; as discussed in my last Twitter Thread. In other threads, I discussed pelvic ligament injuries etiologic for #fibromyalgia...
It would seem to me best way to image #Badgley Book Sign (#BBS) would be with firm seat & Guideon Bible bolsters in upright MRI. If I ever get opportunity to do this, I will write up my finding. MRI can render 3-dimensional images, which might be fantastic.
Reader might have insight why #Badgley Book Sign (#BBS) is good Sign of sacroiliac joint (SIJ) laxity/injury: the mechanical stressor to elicit SIJ rotation & BBS is patient’s own proportional body weight. BBS is measurable, teachable, & reproducible.
#Badgley Book Sign (#BBS) does not rely on patients’ complaints of pain as an end point, a variable attached to most of other Provocation Maneuvers of sacroiliac joint dysfunction; & which is a subjective endpoint measurement.
Once pelvic ligament injury has been specifically diagnosed, then ultrasound-guided stem cell #Prolotherapy might be used to correct this #fibromyalgia causing disorder.
The evaluations & concepts within this Tweet Thread are my own inventions. I have published them at various places on internet & at international symposia. I do not have an academic affiliation, which detracts from my authority.
My dream is to have a #fibromyalgia clinic in Caribbean, where I can help people away from the doctors of the academic guild-fraternity & their exclusively allowed methods & their prejudices vs. inexpensive non-toxic natural therapies.
It is also in the Caribbean where highly trained US Orthopedic Surgeons and other doctors provide stem cell therapy of patient’s own cells to their injured ligaments @RegenexxCayman.
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