Tenderness in the sciatic foramen area

Introduction The tenderness of the ischial size hole area is one of the clinical manifestations of sciatic iliac crest. The abdominal organs or tissues are released through the large holes and small holes of the ischial bone, which is called sciatic hernia. The pelvis is a strong bone ring composed of the posterior tibial tailbone and the hip bones on both sides. The pelvic nodular ligament, the sacrospinous ligament and the large ischial sac are enclosed in the greater sciatic foramen, and the small ischial sciatic foramen. When a large hole in the ischial bone or a muscle around the small hole is weakened due to paralysis or injury, the organ in the lower abdomen and the pelvic cavity can be ejected when the intra-abdominal pressure is increased.

Cause

The pelvis is a strong bone ring composed of the posterior tibial tailbone and the hip bones on both sides. The pelvic nodular ligament, the sacrospinous ligament and the large ischial sac are enclosed in the greater sciatic foramen, and the small ischial sciatic foramen. The upper boundary and the front of the large hole of the ischial bone are the hip bone, the back is the sacral nodular ligament, and the lower boundary is the sacral ligament passing through the hole. There is a piriform muscle. Above it, there are gluteal nerves and blood vessels passing through it, and there is a sciatic nerve below it. The inferior gluteal nerve, the pudendal nerve, and the blood vessels pass through. In front of the ischial hole, the upper part of the ischial tuberosity is the ischial spine and the sacrospinous ligament, followed by the sacral nodular ligament, through which the pudendal nerve and blood vessels, and the obturator inner tendon. When a large hole in the ischial bone or a muscle around the small hole is weakened due to paralysis or injury, the organ in the lower abdomen and the pelvic cavity can be ejected when the intra-abdominal pressure is increased.

an examination

Related inspection

CT check internal pull line check

Clinical manifestations:

1. There is tenderness in the large hole area of the ischial bone, sometimes accompanied by gluteal upper hip or sciatica.

2. There is a mass in the gluteal cleft (ie, the gluteal fold at the gluteal fold), and there is a change in size depending on the position. The mass disappears when the pelvis is in a high position, and there is a local impact when the abdominal pressure is increased. A mass appeared.

3. There is a slight abdominal discomfort in normal times. When the content is incarcerated, symptoms of mechanical intestinal obstruction may occur.

Complications: Incarceration of the intestine can cause intestinal narrowing and necrosis.

Ischial hernia - diagnosis

1. History: middle-aged women have multiple births; reversible masses appear in the gluteal sulcus, and the size changes with body position; there are tenderness or bronchial neuralgia in the size of the ischial size.

2. Signs: Some cases of tenderness in the large hole of the ischial bone or the small hole of the ischial bone can touch the mass in the gluteal sulcus. When the local lumps increase the cough when the abdominal pressure is increased, there is a local impact. Can be returned without incarceration.

3. Auxiliary examination: in line with the ischial sacral sign.

Differential diagnosis

Sciatica: refers to sciatic neuropathy, a group of painful symptoms that occur along the sciatic nerve pathway, ie, the waist, hips, back of the thigh, posterior aspect of the lower leg, and lateral aspect of the foot. The sciatic nerve is the main nerve trunk that governs the lower extremities. Sciatica refers to pain in the sciatic nerve pathway and its distribution (hip, back of the thigh, posterior aspect of the calf, and lateral aspect of the foot). Pubic symphysis separation: refers to pubic symphysis after injury, local pain and pelvic dysfunction, X-ray film, the gap is greater than 6 mm.

Clinically, the pubic symphysis is painful, and there is obvious tenderness. The unilateral lower limbs cannot bear weight, the walking is weak, the lower limbs are difficult to lift, and the waist and buttocks are the main manifestations. Axillary pain: common in the axillary abscess, refers to the abscess caused by purulent infection in the axillary fossa. Often accompanied by chills and high fever, nausea and vomiting, loss of appetite, general malaise, local swelling, axillary pain symptoms.

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