BADGLEY BOOK SIGN
December 27, 2019
Report of a new Sign of Sacroiliac Joint Dysfunction & Subluxation.
December 27, 2019
Report of a new Sign of Sacroiliac Joint Dysfunction & Subluxation.
@dr_tu_gynesurg:
“There are a set of women who appear to have functional pelvic pain but likely have impingement of the sacral nerve roots: how to diagnose them is a huge open field of study:
“There are a set of women who appear to have functional pelvic pain but likely have impingement of the sacral nerve roots: how to diagnose them is a huge open field of study:
(Neuropelveology: An emerging field of study of chronic pelvic pain. In International Neurology Journal. 2(14): 243-246, December 2017).”
Me: Examination of sacral nerve impingement must regard counter-nutation & nutation of the sacroiliac joints; ventral sulcus of which is contiguous to & just dorsal of the pre-sacral plexus.
Chronic recurrent impingement of the pre-sacral neural plexus elicits Chronic Low Back Pain & Chronic Sciatica, as well as IBS & IC (dysautonomias). These are my novel theories & clinical data reports.
The medical literature regards sacroiliac joint dysfunction (subluxation) to be the etiology of chronic pain generation in 13-30% of people with Chronic Low Back Pain.
Best test for examination of SIJ dysfunction is Badgley Book Sign: As patient sits upright on firm seat, a 1” bolster (Gideon Bible works well) is alternately placed under each buttock in turn.
Rotation of a few degrees of SIJ nutation or counted-nutation is observed by noting symmetry
or asymmetry of the anterior tibial plateaus.
or asymmetry of the anterior tibial plateaus.
Station of the anterior tibial plateaus is surrogate marker for sacroiliac joint (SIJ) rotation about a trans-pelvic virtual axis of rotation that is through approximate mid-region of the SIJ.
Nutation & counter-nutation are terms describing relative spacial relationship of ilium & sacrum at SIJ, & as the SIJ rotates through only a few degrees of arc.
A few degrees of SIJ rotation is magnified by a radius (the femur) from SIJ & manifests as 1-3” of asymmetry between the two anterior tibial plateaus.
Nutation manifests as functional lengthening of ipsilateral femur & results from injury to & loss of tethering integrity of the Sacrotuberous ligament system.
Counter-nutation manifests as functional shortening of ipsilateral femur. Counter-nutation is manifestation of injury & loss of tethering integrity of the Iliolumbar ligament system.
The motive force that incites the Badgley Book Sign is gravity. The book bolster transfers ground force of chair seat into SIJ & tips upperbody mass toward one side or other; imposing upper body mass upon each SIJ in turn.
The theories & findings described herein are my own novel discoveries & heretofore reported only within my own writings.
The Badgley Book Sign (BBS) is measurable, reproducible, & teachable. Unlike most of the 16 clinical Provocation Maneuvers of SIJ dysfunction, the BBS does not rely on the patient’s expression of subjective pain as an endpoint.
In 2013, at 8th Interdisciplinary World Congess on Low Back & Pelvic Pain, Dubai, I presented Badgley Book Sign & first world announcement of radiologic study demonstrating SIJ subluxation (published in Proceedings).
As told to me by Dr. Andre Vlemming (world expert on SIJ biomechanics), NASA spent $1M using fluoroscopy to try & show SIJ subluxation during standing “stork” posture.
My radiologic demonstration of sacroiliac joint subluxation was performed on persons seated & by means of the Badgley Book Sign performed while patients were seated on the X-ray table as trans pelvic X-rays were taken.
Diagnosis of sacroiliac joint (SIJ) dysfunction is important. Subluxation of SIJ causes severe & disabling “Sacroiliac Joint Subluxation Chronic Pain Disorder Syndrome” (my term).
In my opinion, treatments for chronic painful sacroiliac joint (SIJ) subluxation include SIJ fusion, SIJ ligament Prolotherapy, & dorsal medial sacral nerve branch radio frequency ablation.
At 10th Interdisciplinary World Congress on Low Back & Pelvic Pain, Antwerp, October 2019, I presented eight (8) papers (on line) about causes & manifestations of Fibromyalgia. SIJ subluxation was a major contributing cause.
CONCLUSION: The Badgley Book Sign (BBS) is the best Sign to demonstrate Sacroiliac Joint Subluxation & Dysfunction.
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