A study of the anatomy and the clinical importance of the sacro-iliac joint / Fred H. Albee.

  • Albee, Fred H. (Fred Houdlett), 1876-1945.
Date:
1909
Catalogue details

Licence: In copyright

Credit: A study of the anatomy and the clinical importance of the sacro-iliac joint / Fred H. Albee. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    <4omy. Kd^ar reported tive cases in which lie obtained from to 2^0 indies of separation at the symphysis fol- lowed by Jinn union and without symptoms. Neverthe- less. this articulation is liable to all the alfections of other joints and in the event of infection the ])rognosis is often serious, because, first, it is very likely to be a metastatic infection from some other ])art of the body, and, second, as described above, on account of the dan- of spontaneous draina«ie forward into the pelvis. ILLUSTKATlVIv C.VSES Cask 1.—History.—Miss X. M., was si*en by me Fob. Iboo. She worked in a web factory; lier previous hi.story was intuitive. Last OctolKW she fell over a larjje stone in the coun- try and .strained her back, and was in bed two weeks. This was followed by inability to .stoop, lie on back, or stand on rij,dit foot, without .severe pain in extreme lower part of the back, which always remained in the same place and became more severe at her menstrual periods, Tiie patient’s only comfortable ])osture was lying on the left side. Hhysicnl h'xfimitiation.—Total lateral spinal curvature to the left. Spine normally flexible. Hip and other joints nor- mal. Very distinct tenderness over tower j>art of right sacro- iliac j«dnt. (ioldthwait’s symptom present, i. e., pain in r<*gion of sacroiliac articulation, when the thigh was flexed with extended leg to a right angle or less. Pain produced by standing on right foot; most .severe, however, when patient attemi)ted to turn over, while in a reclining position. Trrntmcnt.—Pelvis was encirchsl by very tight two-inch bands of surgeons’ adhesive plaster just below the anterior- superior spines of the ilia. Patient reported in one week entire relief. The strapf)ing was reapplied, at ])eriods of a week, four times. A long corset with a four-inch ela.stic web- bing lx*lt at l>ottom to grasp the pelvis was then made, which has l)oen worn with entire relief ever since. Ca.se 2.— nistory.—Miss A., O,, aged L5, was referred to me by Dr. A. A. Crane, Waterbury, Conn., Feb. 20, 1000, She attended school and practiced on the piano a good deal. Pre- vious history was negative. The patient has had pain con- tinuously in lower part of back ever since falling on the ice three years before. There was an increase of pain at the time of each menstrual period, although menstrual fluid had not appeared. Pain was produced by walking, sitting, especially on the affected side, or laying on the back. The patient never lays on the back, always on the left side. Physical Examination.—Fairly well developed and nour- ished girl. Examination negative except for markefl total spinal curvature to the left, Xo rotation. Tenderness over upper part of right sacroiliac joint. Spine normally flexible