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Laurence Badgley, M.D. Profile picture
@BadgleyLaurence
Jul 21, 2019 • 15 tweets • 5 min read • Read on X
#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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More from @BadgleyLaurence

Laurence Badgley, M.D. Profile picture
Apr 16
LOOSE JOINTS, HYPERMOBITY? Gravity is at play in these women with tissue variations. When joint are unstable the obvious compensation is “gorilla” muscles to take over lax ligament efforts. A wise Physical Therapist is key. Lots of dedicated exercise also.
LOOSE JOINTS INHERITED (-15% women) is normal. These woman’s have easier births & indigo-smart children. These women are often quite attractive and smart.
ABORIGINAL SOCIETIES
CHERISHED HYPERMOBILE
WOMEN BECAUSE THEY WERE SMART & PROLIFIC BIRTHERS. INTELLIGENCE GENES LIKELY GROUP WITH HYPERMOBILITY GENES & GENES FOR BEAUTY. MEN WANTED FECUND ATTRACTIVE WOMEN SO THEY SELECTED THEM OUT.
Read 6 tweets
Laurence Badgley, M.D. Profile picture
Apr 14
HYPOPERFUSION? Yes, maybe sympathetic nervous system dominance + decreased pituitary vasopressin causing excess free water elimination in urine ⏩️ decreased blood circulation of hyperosmolar blood.
COVID-CAUSED decreased blood volume of blood that is too thick might explain orthodtstic hypotension, POTS. Might also explain the wormy blood clots.
COVID-CAUSED diminished total blood volume might evoke sympathetic nervous system activation to prevent hypotension and prevent syncope. Diminished blood volume would be expected to deliver less oxygen to tissues ⏩️ fatigue & exercise intolerance.
Read 5 tweets
Laurence Badgley, M.D. Profile picture
Apr 9
TO BE GAY ON NOT, THE QUESTION? In ancient days of the mid last century, the proper medical terminology was “homosexual”. Homo is a Greek prefix for “man” such as used in our species name, homosapiens, I think. Along the way a new adjective/noun, a euphemism, was created, “gay”.
“GAYNESS” might be adverb. I don’t know, grammar not my long suit. In any case, Anthropologist of last century seemed to be of consensus that a fixed ~15% of the population was homosexual as a transcultural genetic characteristic of homosapiens. Indeed, genes direct hormones.
TO BE GAY OR NOT: THE “GREAT H & E DEBATE” (heredity vs. environment) is a dynamic that has ever lent unending entertainment and fascination to the study of the human condition & especially to the world of medical studies.
Read 7 tweets
Laurence Badgley, M.D. Profile picture
Apr 6
MCAS & COVID:
MCAS IN LONG COVID: is possibly etiologic via biomechanisms known about MCAS, HYPERMOBILITY (HS) & FIBROMYALGIA (FM). Persons with HS & FM commonly suffer MCAS. Reason has been theorized that mast cells reside proximate connective tissue.
MCAS, HS, & FM: hyperflexible connective tissue evokes mast cell degranulation. Reactive substances provoke proximate neural tissues. Some experimental data for this dynamic. It might be that those with long COVID & MCAS expression might have hypermobility (about 15% women).
Read 11 tweets
Laurence Badgley, M.D. Profile picture
Mar 12
IC CAUSE DISCOVERED: for years clinicians have been mystified by etiology of IC. Genes, microbes, toxins, & biochemistry have failed to provide insights. IC oft occurs in women who have Hypermobility Syndrome and/or IBS. These circumstances suggest that IC is a dysautonomia.
IC A DYSAUTONOMIA? parasympathetic part of autonomic system stimulates smooth tissues of bladder & bowel to contract/evacuate those organs. Over activity of this neural network is unmeasurable, as yet, in current medical sciences. Absence of evidence is not evidence of absence.
IC CLINICAL DATA: hypermobile women are potentiated for developing pelvic girdle instability from loose sacroiliac joint (SIJ) ligaments & are prone to Mast Cell Activation Syndrome (MCAS). Dr. Afrin’s book explains MCAS. I published case studies of IC remission via SIJ fusion.
Read 9 tweets
Laurence Badgley, M.D. Profile picture
Mar 12
IRRITABLE BOWEL SYNDROME: doctors will tell you the cause is “unknown”. This is not true. IBS is commonly found in women either Hypermobility Syndrome. Reason is that these women are prone to pelvic girdle injuries and ligament laxity of one of the sacroiliac joints.
IBS & HYPERMOBILITY SYNDROME: This association well known in medical circles. Some of these women have regular daily frequent loose stools. Some have intermittent episodes of several days of constipation. Another set of these women have alternating constipation and loose stools.
IBS EXPLAINED: reason cause is “unknown” is that anatomical, tissue, and biochemical explanations are unknown and wanting. However, the dysfunction of the bowel suggests the cause is dysfunction of the autonomic nervous system, the parasympathetic and sympathetic.
Read 14 tweets

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