Section Information: Abstracts of Poster and Platform Presentations for the 2004 Combined Sections Meeting: Poster Presentations
THE PREVALENCE OF PELVIC ASYMMETRY AND SACROILIAC JOINT DYSFUNCTION IN CHILDREN.
M. Drnach, M. Janovich, K. Capdeville, S. Gehring, Physical Therapy, Wheeling Jesuit University, Wheeling, WV.
PURPOSE/HYPOTHESIS: This observational study was done to assess the prevalence of pelvic asymmetry and sacroiliac joint dysfunction in children.
NUMBER OF SUBJECTS: Fifty-three children were recruited from two private schools. Twenty-four females and 29 males consented to be tested. The average age was 9.2 years with a range from 7 to 12 years. Excluded were children who had a history of orthopedic surgery or had a diagnosis of a neurological impairment.
MATERIALS/METHODS: Palpation of bony landmarks including anterior superior iliac spine (ASIS), posterior superior iliac spine (PSIS), and iliac crests were performed in a standard format with the subject standing. Visual evaluation of alignment was done by the examiner, at eye level with the examiner s dominant eye. Comparison was made to determine if one side appeared higher than the other. Leg length measurements were taken from the ASIS to the medial malleolus, and umbilicus to medial malleolus with the subject in the supine position. The threshold for a leg length discrepancy was set at 2 cm or greater. The examination concluded with a cluster of special tests to determine sacroiliac joint dysfunction: standing flexion, sitting PSIS palpation, prone knee flexion and supine long sit test.
RESULTS: The data were analyzed using descriptive statistics (SPSS for Windows, version 9.0). Inter rater agreement of the three examiners for the bony landmark palpation was 92.5% and the inter rater agreement for the cluster of the four special tests was 76.7%. Six out of 53 subjects (11.3%) exhibited pelvic asymmetry. These same 6 subjects had positive findings in the areas of bony landmark palpation and true leg length discrepancy of 2 cm or greater on the same side. No subject had more than one positive special test. Therefore, no subject met the requirements for determining sacroiliac dysfunction as suggested by Cibulka et al.
CONCLUSIONS: Eleven percent of children in this study presented with a pelvic asymmetry with a concurrent true leg length discrepancy of 2 cm or greater on the side of the pelvis that appeared higher upon visual examination. No subject demonstrated sacroiliac joint dysfunction as noted by a cluster of special tests.
CLINICAL RELEVANCE: This study contributes to the understanding of the prevalence of pelvic asymmetry and sacroiliac joint dysfunction in typically developing children. The information is useful in the evaluation of clinical findings in the orthopedic examination of a child.