Ultrasonographic Determination of Pubic Symphyseal Widening in Trauma: The FAST-PS Study

Bauman, Michael; Marinaro, Jonathan; Tawil, Isaac; Crandall, Cameron; Rosenbaum, L; Paul, Ian M.

doi:10.1016/j.jemermed.2009.08.041

Cited by 16 publications

(10 citation statements)

References 7 publications

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“…Some quantitative data on joint width are available from previous imaging studies (Abramson et al, ; Barnes, ; Roberts, ; Vix and Ryu, ; Sgambati et al, ; Wurdinger et al, ; Alicioglu et al, ) but direct comparison with our data is difficult because of the different techniques used, imprecise descriptions of exactly where the joint was assessed and inhomogeneous study groups of unknown or mixed parity. For example, in three previous sonographic studies the authors did not distinguish narrow and wide joint widths, which could impact significantly on overall mean values (Björklund et al, ; Schoellner et al, ; Bauman et al, ). Nevertheless, mean wide joint width of approximately 10 mm in the present study is similar to the value of 16 mm reported in an ultrasound study of 32 women of similar age but mixed parity during labour (Rustamova et al, ).…”

Section: Discussionmentioning

confidence: 96%

“…Of the five anatomic variables assessed by ultrasound, measurement of pubic symphysis width and SPL length are potentially the most useful clinically, as they are more likely to change during and after pregnancy. The width of the pubic symphysis has previously attracted particular interest in ultrasound examination of the joint in nonpregnant women (Björklund et al, ; Weber et al, ; Schoellner et al, ; Bauman et al, ) because of the widespread view that widening of the pubic symphysis during pregnancy is related to the development of symphyseal pain (Hagen, ).…”

Section: Discussionmentioning

confidence: 99%

“…The joint, primarily adapted for stability, comprises the left and right medial pubic articular surfaces firmly bound together by a fibrocartilaginous disk and reinforced by surrounding pubic ligaments (Becker et al, ). Increasingly, the joint has been investigated using various imaging modalities, particularly during pregnancy, but quantitative in vivo data are confined to a small number of investigations (Björklund et al, ; Weber et al, ; Schoellner et al, ; Wurdinger et al, ; Alicioglu et al, ; Bauman et al, ). Several studies have focused exclusively on joint width (Vix and Ryu, ; Björklund et al, ; Sgambati et al, ; Alicioglu et al, ) but little is known about other anatomic parameters that could also be relevant to clinical investigation.…”

Section: Introductionmentioning

confidence: 99%

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Sonographic anatomy of the pubic symphysis in healthy nulliparous women

Becker

Stringer

Jeffery³

et al. 2014

Clinical Anatomy

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Pregnancy-related symphyseal pain is a condition commonly encountered by clinicians but its pathogenesis is poorly understood. The pubic symphysis is readily visualized with ultrasound, yet the normal sonographic anatomy of the joint has not been accurately documented. This study aimed to describe the anatomy of the pubic symphysis in healthy, nulliparous women using ultrasound. An experienced and inexperienced sonographer scanned the joint in 30 female volunteers (mean age 26 years). Interobserver and intraobserver reliability of ultrasound measurements were examined and the accuracy of these measurements was validated by ultrasound and dissection of six female cadaver pelves (mean age 75 years). In healthy young women, pubic symphysis morphology varied, and six categories of anterosuperior joint shape were defined. Mean values of several anatomic parameters were obtained in supine and standing positions: joint width (widest 10.1 mm, narrowest 2.6 mm); superior pubic ligament (SPL) length and depth (41.4 and 3.4 mm, respectively); and pubic crest length (left 24.4 mm, right 24.4 mm). Statistically significant relationships between SPL width and depth and anthropometric variables (body mass index, pelvic width, and body fat percentage) were established. Larger ultrasonographic measurements, such as wide joint width and SPL length, could be measured more reliably than smaller measurements, such as narrow joint width and SPL depth, in both healthy volunteers and cadavers. Findings from this study provide normative reference data for examination of the pubic symphysis in pregnant women and may therefore be relevant to understand pregnancy-related symphyseal pain.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sonographic anatomy of the pubic symphysis in healthy nulliparous women

Becker

Stringer

Jeffery³

et al. 2014

Clinical Anatomy

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“…The secondary survey, performed once the airway, breathing and circulation are stabilised, is a systematic examination of the child to detect non‐life threatening injuries. Ultrasound can be used to improve the detection of orbital and skeletal injuries including long‐bone fractures and pelvic diastasis Respiratory presentations …”

Section: Diagnostic Ultrasoundmentioning

confidence: 99%

Point‐of‐care ultrasound in paediatric emergency medicine

O’Brien

Brady

2016

J Paediatrics Child Health

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Point-of-care ultrasound (POC US) is an adjunct to clinical paediatric emergency medicine practice that is rapidly evolving, improving the outcomes of procedural techniques such as vascular access, nerve blocks and fluid aspiration and showing the potential to fast-track diagnostic streaming in a range of presenting complaints and conditions, from shock and respiratory distress to skeletal trauma. This article reviews the procedural and diagnostic uses, both established and emerging, and provides an overview of the necessary components of quality assurance during this introductory phase.

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“…This modality could potentially lead to faster application of a pelvic binder and tamponade of bleeding, 82 especially if there was a delay in obtaining the pelvic radiograph.…”

Section: Diagnosis Of Pelvic Fracturementioning

confidence: 99%