The Biomechanics of the Sacroiliac Joint in Health and Disease: A Narrative Review

Abstract

The sacroiliac (SI) joint is cited as the primary source of pain in 10% to 25% of patients with low back pain. The SI joint is primarily designed for stability, distributing the weight of the upper body and spine to the lower extremities, limiting the rotation of the trunk over the pelvis, and facilitating childbirth in pregnant women. It is generally accepted that joint movement occurs in three body planes, but as age advances, movement gradually decreases. Unique anatomical and physiological features make the joint sensitive to mechanical stress and also create challenges in diagnosing SI joint pain. Changes or injuries in the biomechanics of the SI joint result in alterations in surrounding tissues such as muscles and ligaments, which become accentuated with pain. Despite the presence of a significant number of patients experiencing SI joint dysfunction, there are disagreements regarding optimal methods for diagnosis and treatment since symptoms inconsistently manifest among patients. This review aims to emphasize the importance of functional joint biomechanics while assessing the anatomy and kinematics of the SI joint and to examine the pathomechanics observed in SI joint dysfunction and inflammatory diseases.

Keywords

• Sacroiliac joint
• joint pain
• low back pain
• inflammation

Sakroiliyak Eklem Biyomekaniği Sağlık ve Hastalıkta: Bir Anlatısal Derleme

Abstract

Sakroiliyak (Sİ) eklem, bel ağrısı olan hastaların %10 ile %25'inde birincil ağrı kaynağı olarak belirtilen bir eklemdir. Sİ eklem öncelikli olarak stabiliteye yönelik tasarlanmış olup vücudun üst kısmı ve omurganın ağırlığını dağıtarak alt ekstremitelere iletmek, gövdenin pelvis üzerindeki dönüşünü sınırlamak ve hamile kadınlarda doğumun kolaylaştırılmasını sağlamak gibi temel işlevleri bulunur. Genel anlamda eklemdeki hareketin 3 vücut düzleminde meydana geldiği, ancak ilerleyen yaşla birlikte hareketin yavaş yavaş azaldığı kabul görmüştür. Benzersiz anatomik ve fizyolojik özellikleri, eklemi mekanik strese karşı duyarlı hale getirir ve aynı zamanda Sİ eklem ağrısının tanısında zorluklar yaratır. Sİ eklemin biyomekaniğindeki değişiklik veya yaralanmalar sonucunda kas ve ligament gibi çevre dokularda meydana gelen değişiklikler ağrı ile belirginleşir. Sakroiliyak eklem disfonksiyonu yaşayan çok sayıda hasta olmasına rağmen, semptomlar hastalar arasında tutarsız bir şekilde ortaya çıktığından tanı ve tedavi için optimal yöntemler konusunda anlaşmazlıklar vardır. Bu derleme, Sİ ekleminin anotomi ve kinematiğini değerlendirirken fonksiyonel eklem biyomekaniğinin önemini vurgulamayı ve Sİ eklem disfonksiyonu ve inflamatuar hastalıklarında görülen patomekaniği incelemeyi amaçlamaktadır.

Keywords

• Sakroiliyak eklem
• eklem ağrısı
• bel ağrısı
• inflamasyon

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