RESUMO
BACKGROUND: The sacroiliac joint is a common cause of low back pain. Due to variable symptoms, the diagnosis is often very difficult. For diagnosis, systemic disease, as well as pathologies in the hips and lumbar spine must be excluded. OBJECTIVES: To describe anatomy and function of the joint and underlying pathologies. To present the evidence of actual diagnostic and therapeutic options. MATERIALS AND METHODS: An extensive literature research was carried out on PubMed. RESULTS: The sacroiliac joint is an important and biomechanically complex joint. There are many controversial diagnostic tests to identify the sacroiliac joint as a source of pain. The cause of the dysfunction must be identified in order to treat it correctly and to prevent a chronification of the pain. The gold standard is conservative care. CONCLUSION: The sacroiliac joint must be included in the differential diagnosis in patients with low back pain. Diagnostic tests are often insufficient for the diagnosis of sacroiliac joint pain. Many of the current diagnostic and therapeutic options present weak evidence.
Assuntos
Artralgia/etiologia , Dor Lombar , Articulação Sacroilíaca , Artralgia/diagnóstico , Humanos , Dor Lombar/diagnóstico , Dor Lombar/etiologia , Dor Lombar/patologia , Vértebras Lombares , Articulação Sacroilíaca/anatomia & histologia , Articulação Sacroilíaca/diagnóstico por imagem , Articulação Sacroilíaca/fisiologiaRESUMO
A total of 100 persons who had been repeatedly convicted of drunken driving were submitted to assessment by a medical expert. A series of uniform criteria were used to determine whether they suffered from alcoholism. The following methods of investigation were used: 1. a conversation relating to drinking habits, psychosocial background and sociological circumstances; 2. the MALT (Munich alcoholism test); 3. physical examination; 4. laboratory tests. Using these methods it was possible to distribute those examined into one of the following groups (according to WHO and Jellinek): non-alcoholics (10%), problem drinkers (49%) and addicted drinkers (41%). These three large groups presented a typical picture in respect of age, occupational group, blood alcohol concentration/journey, MALT index, pathological findings at physical examination and abnormally raised laboratory values. In particular, the triad of MCV, gamma-GT and macrocytosis played an important role in aiding the recognition of alcoholism or alcohol dependence. The additional presence of a raised value for SGPT further supported the diagnosis. In 37% of cases, regular alcoholic intake began during basic military service and in 28% at the place of work (mostly on building sites). In both of these groups it would appear important to institute appropriate preventive measures.