Abstract

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

Cause

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

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.

Diagnosis | 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). A vertical displacement of more than 1 cm is an indicator of symphysis pubis instability. A displacement of more than 2 cm usually indicates involvement of the sacroiliac joints.

Diagnosis | 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 and any abnormal posturing of the pelvic joints.