WordNet

relating or near the pubis; "pubic bones"; "pubic hair"
a growing together of parts or structures
an abnormal adhesion of two or more structures
separation of an epiphysis from the long bone to which it is normally attached without fracture of the bone

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/13 22:57:25」(JST)

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Diastasis symphysis pubis is the separation of normally joined pubic bones, as in the dislocation of the bones, without a fracture.

Diagnosis

This abnormally wide gap can be diagnosed by radiologic studies such as x-ray, MRI, CT scan or bone scan. Manual testing by a healthcare professional can also be used. The patient is placed in various positions and pressure is applied in such a way that it provokes pain and maybe movement in the pubis.

X-ray

An X-ray film will show a marked gap between the pubic bones, normally there is a 4–5 mm gap but in pregnancy, hormonal influences cause relaxation of the connecting ligaments and the bones separate up to 9 mm. To demonstrate instability of the joint the patient is required to stand in the "flamingo" position, (standing with weight on one leg and the other bent).^[1] A vertical displacement of more than 1 cm is an indicator of symphysis pubis instability.^[2] A displacement of more than 2 cm usually indicates involvement of the sacroiliac joints.

CT scan and MRI

Both diagnostic machines can produce detailed cross sections of the pelvic area. Images will show degrees soft tissue injury, inflammation of the subchondral region and the bone marrow ^[3] and any abnormal posturing of the pelvic joints.

Bone Scan

A bone scan is able to determine areas of bone inflammation.

External forces

External forces such as falling from a horse or a car accident can result in this type of injury to the symphysis pubis.

In former times obstructed childbirth was sometimes treated by cutting the pubic symphysis (symphysiotomy), letting the pelvis halves hinge outwards at the sacroiliac joints.

Other conditions

In bladder extrophy^[4] there is a gap between the pubis, which are joined by a strong interpubic ligament.

References

^ An Analysis of Pubis Symphysis Misalignment Using Plain Film Radiography Ruch WJ, Ruch BM. J Manipulative Physiol Ther. 2005;28(5):330-335
^ Vertically Unstable Pelvic Fractures Fixed with Percutaneous Iliosacral Screws: Does Posterior Injury Predict Fixation Failure? Damian R. Griffin, MA, FRCS (Orth); Adam J. Starr, MD; Charles M. Reinert , MD; Alan L. Jones, MD; Shelly Whitlock, CCRA; University of Texas Southwestern Medical Center, Dallas, TX
^ Magnetic resonance imaging changes of sacroiliac joints in patients with recent-onset inflammatory back pain: inter-reader reliability and prevalence of abnormalities. Arthritis Research & Therapy 2006, 8:R11 doi:10.1186/ar1859. Liesbeth Heuft-Dorenbosch1, René Weijers, Robert Landewé1, Sjef van der Linden1, Désirée van der Heijde1
^ http://www.bartleby.com/107/255.html (end of page)

External links

Diastasis Symphysis Pubis Support Forum
Pelvic Instability Network Support (PINS)
Pictures and explanation at e-radiography.net

UpToDate Contents

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1. 妊娠中および産後の筋骨格系の変化および疼痛 musculoskeletal changes and pain during pregnancy and postpartum
2. 急性腰仙部神経根障害：病態生理、臨床的特徴、および診断 acute lumbosacral radiculopathy pathophysiology clinical features and diagnosis
3. 膀胱外反症を有する幼児の臨床症状および初期マネージメント clinical manifestations and initial management of infants with bladder exstrophy
4. 膀胱外反症を有する小児の外科的マネージメントおよび術後経過 surgical management and postoperative outcome of children with bladder exstrophy
5. 胎児腹壁破裂および総排泄腔外反症 body stalk anomaly and cloacal exstrophy

English Journal

Pubic symphysis diastasis sustained from a waterslide injury.

Williamson M1, Vanacore F1, Hing C1.
Journal of clinical orthopaedics and trauma.J Clin Orthop Trauma.2018 Jun;9(Suppl 2):S32-S34. doi: 10.1016/j.jcot.2018.01.002. Epub 2018 Jan 4.
PMID 29928101

[Case-control study on clinical effects of squeezing and clapping manipulation for treating the postpartum pubic symphysis separation].

Yu D, Wang SQ1, Sun SC, Shi ZT, Liu ST, Ye YY.
Zhongguo gu shang = China journal of orthopaedics and traumatology.Zhongguo Gu Shang.2018 May 25;31(5):431-435. doi: 10.3969/j.issn.1003-0034.2018.05.007.
PMID 29890802

Surgical and endoscopic treatment of bladder exstrophy-epispadias complex in a female dog.

Jones B, Berent AC, Weisse CW, Hart R, Alvarez L, Fischetti A, Horn BD, Canning D.
Journal of the American Veterinary Medical Association.J Am Vet Med Assoc.2018 Mar 15;252(6):732-743. doi: 10.2460/javma.252.6.732.
CASE DESCRIPTION A 14-week-old 7.7-kg (16.9-lb) sexually intact female Golden Retriever was evaluated because of urine dripping from the caudoventral aspect of the abdomen. CLINICAL FINDINGS Ultrasonography, radiography, excretory CT urography, and vaginocystourethroscopy were performed. Results ind
PMID 29504860