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Musculoskeletal Imaging in the Pregnant and Postpartum Patient

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Musculoskeletal Health in Pregnancy and Postpartum

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Abstract

Musculoskeletal (MSK) imaging in the pregnant and postpartum patient includes advanced magnetic resonance imaging (MRI) with fluid-sensitive sequences which depict bone and muscle injuries not detected by other MRI studies and ultrasound. Neither produces ionizing radiation and, in most cases, intravenous contrast is not needed limiting risks even in pregnant patients. With MSK-specific MRI, new insights can be gained on stress injuries/fractures in the pelvis and pain syndromes, osteitis pubis, osteitis condensans ilii, transient osteopenia of the hip, and sports-related injuries. Muscle and skeletal injuries associated with childbirth including pubic and sacral diastasis can be evaluated more completely providing information, which may lead to improved management. Pelvic MSK infections can be diagnosed earlier with the use of MSK MRI preventing complications. Ultrasound can be used for evaluation of superficial MSK structures and for detection of round ligament varicosities and occult hernias during pregnancy. Advances in MRI with MR neurography and in high-resolution ultrasound increase the value imaging can provide in the diagnosis and management of neuropathy in those patients with atypical or severe presentations.

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References

  1. Zajick DC, Zoga AC, Omar IM, Meyers WC. Spectrum of MRI findings in clinical athletic pubalgia. Semin Musculoskelet Radiol. 2008;12(1):3–12. PubMed PMID: 18382940.

    Article  PubMed  Google Scholar 

  2. Katz DS, Klein MA, Ganson G, Hines JJ. Imaging of abdominal pain in pregnancy. Radiol Clin North Am. 2012;50(1):149–71. PubMed PMID: 22099493.

    Article  PubMed  Google Scholar 

  3. Tremblay E, Therasse E, Thomassin-Naggara I, Trop I. Quality initiatives: guidelines for use of medical imaging during pregnancy and lactation. Radiographics. 2012;32(3):897–911. PubMed PMID: 22403117.

    Article  PubMed  Google Scholar 

  4. Wang PI, Chong ST, Kielar AZ, Kelly AM, Knoepp UD, Mazza MB, et al. Imaging of pregnant and lactating patients: part 1, evidence-based review and recommendations. AJR Am J Roentgenol. 2012;198(4):778–84. PubMed PMID: 22451541.

    Article  PubMed  Google Scholar 

  5. Klauser AS, Tagliafico A, Allen GM, Boutry N, Campbell R, Court-Payen M, et al. Clinical indications for musculoskeletal ultrasound: a Delphi-based consensus paper of the European Society of Musculoskeletal Radiology. Eur Radiol. 2012;22(5):1140–8. PubMed PMID: 22453857.

    Article  PubMed  Google Scholar 

  6. Paajanen H, Hermunen H, Karonen J. Effect of heavy training in contact sports on MRI findings in the pubic region of asymptomatic competitive athletes compared with non-athlete controls. Skeletal Radiol. 2011;40(1):89–94. PubMed PMID: 20582412.

    Article  PubMed  Google Scholar 

  7. Del Grande F, Santini F, Herzka DA, Aro MR, Dean CW, Gold GE, et al. Fat-suppression techniques for 3-T MR imaging of the musculoskeletal system. Radiographics. 2014;34(1):217–33. PubMed PMID: 24428292.

    Article  PubMed  Google Scholar 

  8. Leadbetter RE, Mawer D, Lindow SW. Symphysis pubis dysfunction: a review of the literature. J Matern Fetal Neonatal Med. 2004;16(6):349–54. PubMed PMID: 15621554.

    Article  CAS  PubMed  Google Scholar 

  9. Aslan E, Fynes M. Symphysial pelvic dysfunction. Curr Opin Obstet Gynecol. 2007;19(2):133–9. PubMed PMID: 17353681.

    Article  PubMed  Google Scholar 

  10. Hansen A, Jensen DV, Larsen EC, Wilken-Jensen C, Kaae BE, Frolich S, et al. Postpartum pelvic pain–the “pelvic joint syndrome”: a follow-up study with special reference to diagnostic methods. Acta Obstet Gynecol Scand. 2005;84(2):170–6. PubMed PMID: 15683379.

    Article  PubMed  Google Scholar 

  11. Kanakaris NK, Roberts CS, Giannoudis PV. Pregnancy-related pelvic girdle pain: an update. BMC Med. 2011;9:15. PubMed PMID: 21324134. Pubmed Central PMCID: 3050758.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Prather H, Dugan S, Fitzgerald C, Hunt D. Review of anatomy, evaluation, and treatment of musculoskeletal pelvic floor pain in women. PM R. 2009;1(4):346–58. PubMed PMID: 19627918.

    Article  PubMed  Google Scholar 

  13. Albert H, Godskesen M, Westergaard J. Prognosis in four syndromes of pregnancy-related pelvic pain. Acta Obstet Gynecol Scand. 2001;80(6):505–10. PubMed PMID: 11380285.

    CAS  PubMed  Google Scholar 

  14. Apte G, Nelson P, Brismee JM, Dedrick G, Justiz 3rd R, Sizer Jr PS. Chronic female pelvic pain–part 1: clinical pathoanatomy and examination of the pelvic region. Pain Pract. 2012;12(2):88–110. PubMed PMID: 21615678.

    Article  PubMed  Google Scholar 

  15. Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008;17(6):794–819. PubMed PMID: 18259783. Pubmed Central PMCID: 2518998.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Handa VL, Lockhart ME, Kenton KS, Bradley CS, Fielding JR, Cundiff GW, et al. Magnetic resonance assessment of pelvic anatomy and pelvic floor disorders after childbirth. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(2):133–9. PubMed PMID: 18846311. Pubmed Central PMCID: 2916750.

    Article  PubMed  Google Scholar 

  17. Hayat SK, Thorp Jr JM, Kuller JA, Brown BD, Semelka RC. Magnetic resonance imaging of the pelvic floor in the postpartum patient. Int Urogynecol J Pelvic Floor Dysfunct. 1996;7(6):321–4. PubMed PMID: 9203480.

    Article  CAS  PubMed  Google Scholar 

  18. Hoyte L, Damaser MS. Magnetic resonance-based female pelvic anatomy as relevant for maternal childbirth injury simulations. Ann N Y Acad Sci. 2007;1101:361–76. PubMed PMID: 17363445.

    Article  PubMed  Google Scholar 

  19. Huerta-Enochian GS, Katz VL, Fox LK, Hamlin JA, Kollath JP. Magnetic resonance-based serial pelvimetry: do maternal pelvic dimensions change during pregnancy? Am J Obstet Gynecol. 2006;194(6):1689–94. PubMed PMID: 16731086, discussion 94-5.

    Article  PubMed  Google Scholar 

  20. Novellas S, Chassang M, Verger S, Bafghi A, Bongain A, Chevallier P. MR features of the levator ani muscle in the immediate postpartum following cesarean delivery. Int Urogynecol J. 2010;21(5):563–8. PubMed PMID: 20024647.

    Article  PubMed  Google Scholar 

  21. Wurdinger S, Humbsch K, Reichenbach JR, Peiker G, Seewald HJ, Kaiser WA. MRI of the pelvic ring joints postpartum: normal and pathological findings. J Magn Reson Imaging. 2002;15(3):324–9. PubMed PMID: 11891978.

    Article  PubMed  Google Scholar 

  22. Singh AK, Desai H, Novelline RA. Emergency MRI of acute pelvic pain: MR protocol with no oral contrast. Emerg Radiol. 2009;16(2):133–41. PubMed PMID: 18649091.

    Article  PubMed  Google Scholar 

  23. Leyendecker JR, Gorengaut V, Brown JJ. MR imaging of maternal diseases of the abdomen and pelvis during pregnancy and the immediate postpartum period. Radiographics. 2004;24(5):1301–16. PubMed PMID: 15371610.

    Article  PubMed  Google Scholar 

  24. Borg-Stein J, Dugan SA. Musculoskeletal disorders of pregnancy, delivery and postpartum. Phys Med Rehabil Clin N Am. 2007;18(3):459–76, ix, PubMed PMID: 17678762.

    Article  PubMed  Google Scholar 

  25. Han IH. Pregnancy and spinal problems. Curr Opin Obstet Gynecol. 2010;22(6):477–81. PubMed PMID: 20930629.

    Article  PubMed  Google Scholar 

  26. Fitzgerald CM. Pregnancy-related lumbopelvic pain: what have we learned? Am J Obstet Gynecol. 2013;208(4):242. PubMed PMID: 23465783.

    Article  PubMed  Google Scholar 

  27. Sabino J, Grauer JN. Pregnancy and low back pain. Curr Rev Musculoskelet Med. 2008;1(2):137–41. PubMed PMID: 19468887. Pubmed Central PMCID: 2684210.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Gutke A, Ostgaard HC, Oberg B. Predicting persistent pregnancy-related low back pain. Spine. 2008;33(12):E386–93. PubMed PMID: 18496334.

    Article  PubMed  Google Scholar 

  29. Davis PC, Wippold 2nd FJ, Brunberg JA, Cornelius RS, De La Paz RL, Dormont PD, et al. ACR appropriateness criteria on low back pain. J Am Coll Radiol. 2009;6(6):401–7. PubMed PMID: 19467485.

    Article  PubMed  Google Scholar 

  30. Jans L, Van Praet L, Elewaut D, Van den Bosch F, Carron P, Jaremko JL, et al. MRI of the SI joints commonly shows non-inflammatory disease in patients clinically suspected of sacroiliitis. Eur J Radiol. 2014;83(1):179–84. PubMed PMID: 24168927.

    Article  CAS  PubMed  Google Scholar 

  31. Sax TW, Rosenbaum RB. Neuromuscular disorders in pregnancy. Muscle Nerve. 2006;34(5):559–71. PubMed PMID: 16969835.

    Article  CAS  PubMed  Google Scholar 

  32. Kowe O, Waters JH. Neurologic complications in the patient receiving obstetric anesthesia. Neurol Clin. 2012;30(3):823–33. PubMed PMID: 22840791.

    Article  PubMed  Google Scholar 

  33. Kiuru MJ, Pihlajamaki HK, Ahovuo JA. Fatigue stress injuries of the pelvic bones and proximal femur: evaluation with MR imaging. Eur Radiol. 2003;13(3):605–11. PubMed PMID: 12594565.

    Article  PubMed  Google Scholar 

  34. Datir AP. Stress-related bone injuries with emphasis on MRI. Clin Radiol. 2007;62(9):828–36. PubMed PMID: 17662729.

    Article  CAS  PubMed  Google Scholar 

  35. Miller C, Major N, Toth A. Pelvic stress injuries in the athlete: management and prevention. Sports Med. 2003;33(13):1003–12. PubMed PMID: 14606927.

    Article  PubMed  Google Scholar 

  36. Black AJ, Topping J, Durham B, Farquharson RG, Fraser WD. A detailed assessment of alterations in bone turnover, calcium homeostasis, and bone density in normal pregnancy. J Bone Miner Res. 2000;15(3):557–63. PubMed PMID: 10750571.

    Article  CAS  PubMed  Google Scholar 

  37. Kanberoglu K, Kantarci F, Cebi D, Yilmaz MH, Kurugoglu S, Bilici A, et al. Magnetic resonance imaging in osteomalacic insufficiency fractures of the pelvis. Clin Radiol. 2005;60(1):105–11. PubMed PMID: 15642300.

    Article  CAS  PubMed  Google Scholar 

  38. Nattiv A, Kennedy G, Barrack MT, Abdelkerim A, Goolsby MA, Arends JC, et al. Correlation of MRI grading of bone stress injuries with clinical risk factors and return to play: a 5-year prospective study in collegiate track and field athletes. Am J Sports Med. 2013;41(8):1930–41. PubMed PMID: 23825184.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Boden BP, Osbahr DC, Jimenez C. Low-risk stress fractures. Am J Sports Med. 2001;29(1):100–11. PubMed PMID: 11206247.

    Article  CAS  PubMed  Google Scholar 

  40. Karadeli E, Uslu N. Postpartum sacral fracture presenting as lumbar pain. J Womens Health. 2009;18(5):663–5. PubMed PMID: 19405869.

    Article  Google Scholar 

  41. Park J, Ok E, Park HJ, Hong SH, Lee JI. Postpartum sacral stress fracture mimicking lumbar radiculopathy in a patient with pregnancy-associated osteoporosis. Ann Rehabil Med. 2013;37(4):582–5. PubMed PMID: 24020042. Pubmed Central PMCID: 3764356.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Beltran LS, Bencardino JT. Lower back pain after recently giving birth: postpartum sacral stress fractures. Skeletal Radiol. 2011; 40(4):461–2, 81–2. PubMed PMID: 21063704.

    Google Scholar 

  43. Goeb V, Strotz V, Verdet M, Le Loet X, Vittecoq O. Post-partum sacral fracture associated with heparin treatment. Clin Rheumatol. 2008;27 Suppl 2:S51–3. PubMed PMID: 18458990.

    Article  PubMed  Google Scholar 

  44. Karatas M, Basaran C, Ozgul E, Tarhan C, Agildere AM. Postpartum sacral stress fracture: an unusual case of low-back and buttock pain. Am J Phys Med Rehabil. 2008;87(5):418–22. PubMed PMID: 18303473.

    Article  PubMed  Google Scholar 

  45. Ozturk G, Kulcu DG, Aydog E. Intrapartum sacral stress fracture due to pregnancy-related osteoporosis: a case report. Arch Osteoporos. 2013;8(1–2):139. PubMed PMID: 23615864.

    Article  PubMed  Google Scholar 

  46. Thein R, Burstein G, Shabshin N. Labor-related sacral stress fracture presenting as lower limb radicular pain. Orthopedics. 2009;32(6):447. PubMed PMID: 19634811.

    PubMed  Google Scholar 

  47. Celik EC, Oflouglu D, Arioglu PF. Postpartum bilateral stress fractures of the sacrum. Int J Gynaecol Obstet. 2013;121(2):178–9. PubMed PMID: 23312399.

    Article  PubMed  Google Scholar 

  48. Pishnamaz M, Sellei R, Pfeifer R, Lichte P, Pape HC, Kobbe P. Low back pain during pregnancy caused by a sacral stress fracture: a case report. J Med Case Reports. 2012;6:98. PubMed PMID: 22475388. Pubmed Central PMCID: 3375193.

    Article  Google Scholar 

  49. Hermann KG, Halle H, Reisshauer A, Schink T, Vsianska L, Muhler MR, et al. [Peripartum changes of the pelvic ring: usefulness of magnetic resonance imaging]. RoFo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin. 2007; 179(12):1243–50. PubMed PMID: 17929216. Peripartale Veranderungen des Beckenringes: Wie sinnvoll ist die Magnetresonanztomografie?

    Google Scholar 

  50. Brandon C, Jacobson JA, Low LK, Park L, DeLancey J, Miller J. Pubic bone injuries in primiparous women: magnetic resonance imaging in detection and differential diagnosis of structural injury. Ultrasound Obstet Gynecol. 2012;39(4):444–51. PubMed PMID: 21728205. Pubmed Central PMCID: 3625969.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Miller JM, Brandon C, Jacobson JA, Low LK, Zielinski R, Ashton-Miller J, et al. MRI findings in patients considered high risk for pelvic floor injury studied serially after vaginal childbirth. AJR Am J Roentgenol. 2010;195(3):786–91. PubMed PMID: 20729461. Pubmed Central PMCID: 3189698.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Gibbon WW, Hession PR. Diseases of the pubis and pubic symphysis: MR imaging appearances. AJR Am J Roentgenol. 1997;169(3):849–53. PubMed PMID: 9275910.

    Article  CAS  PubMed  Google Scholar 

  53. Khan W, Zoga AC, Meyers WC. Magnetic resonance imaging of athletic pubalgia and the sports hernia: current understanding and practice. Magn Reson Imaging Clin N Am. 2013;21(1):97–110. PubMed PMID: 23168185.

    Article  PubMed  Google Scholar 

  54. Boden BP, Osbahr DC. High-risk stress fractures: evaluation and treatment. J Am Acad Orthop Surg. 2000;8(6):344–53. PubMed PMID: 11104398.

    Article  CAS  PubMed  Google Scholar 

  55. Anai T, Urata K, Mori A, Miyazaki F, Okamoto S. Transient osteoporosis of the hip in pregnancy associated with generalized low bone mineral density–a case report. Gynecol Obstet Invest. 2013;76(2):133–8. PubMed PMID: 23796944.

    Article  PubMed  Google Scholar 

  56. Steib-Furno S, Luc M, Pham T, Armingeat T, Porcu G, Gamerre M, et al. Pregnancy-related hip diseases: incidence and diagnoses. Joint Bone Spine. 2007;74(4):373–8. PubMed PMID: 17560159.

    Article  PubMed  Google Scholar 

  57. Rajak R, Camilleri J. An unusual cause of hip pain. BMJ Case Rep. 2011;2011. PubMed PMID: 22679319. Pubmed Central PMCID: 3185398.

    Google Scholar 

  58. Wood ML, Larson CM, Dahners LE. Late presentation of a displaced subcapital fracture of the hip in transient osteoporosis of pregnancy. J Orthop Trauma. 2003;17(8):582–4. PubMed PMID: 14504581.

    Article  PubMed  Google Scholar 

  59. Ward KA, Adams JE, Mughal MZ. Bone status during adolescence, pregnancy and lactation. Curr Opin Obstet Gynecol. 2005;17(4):435–9. PubMed PMID: 15976553.

    Article  PubMed  Google Scholar 

  60. Spinarelli A, Patella V, Speciale D, Petrera M, Vittore D, Pesce V, et al. Hip fracture in a patient affected by transient osteoporosis of the femoral head during the last trimester of pregnancy. Orthopedics. 2009;32(5):365. PubMed PMID: 19472951.

    PubMed  Google Scholar 

  61. Aigner N, Meizer R, Meraner D, Becker S, Meizer E, Landsiedl F. Bone marrow edema syndrome in postpartal women: treatment with iloprost. Orthop Clin North Am. 2009;40(2):241–7. PubMed PMID: 19358909.

    Article  PubMed  Google Scholar 

  62. Clemetson IA, Popp A, Lippuner K, Ballmer F, Anderson SE. Postpartum osteoporosis associated with proximal tibial stress fracture. Skeletal Radiol. 2004;33(2):96–8. PubMed PMID: 14714147.

    Article  CAS  PubMed  Google Scholar 

  63. Daniel RS, Farrar EK, Norton HR, Nussbaum AI. Bilateral transient osteoporosis of the talus in pregnancy. Osteoporos Int. 2009;20(11):1973–5. PubMed PMID: 19343470.

    Article  CAS  PubMed  Google Scholar 

  64. Nitsche JF, Howell T. Peripartum pubic symphysis separation: a case report and review of the literature. Obstet Gynecol Surv. 2011;66(3):153–8. PubMed PMID: 21689485.

    Article  PubMed  Google Scholar 

  65. Topuz S, Citil I, Iyibozkurt AC, Dursun M, Akhan S, Has R, et al. Pubic symphysis diastasis: imaging and clinical features. Eur J Radiol Extra. 2006;59:127–9.

    Article  Google Scholar 

  66. Cowling PD, Rangan A. A case of postpartum pubic symphysis diastasis. Injury. 2010;41(6):657–9. PubMed PMID: 20152970.

    Article  CAS  PubMed  Google Scholar 

  67. Dunivan GC, Hickman AM, Connolly A. Severe separation of the pubic symphysis and prompt orthopedic surgical intervention. Obstet Gynecol. 2009;114(2 Pt 2):473–5. PubMed PMID: 19622966.

    Article  PubMed  Google Scholar 

  68. Shim JH, Oh DW. Case report: physiotherapy strategies for a woman with symphysis pubis diastasis occurring during labour. Physiotherapy. 2012;98(1):89–91. PubMed PMID: 22265390.

    Article  PubMed  Google Scholar 

  69. Hou Z, Riehl JT, Smith WR, Strohecker KA, Maloney PJ. Severe postpartum disruption of the pelvic ring: report of two cases and review of the literature. Patient Saf Surg. 2011;5(1):2. PubMed PMID: 21232102. Pubmed Central PMCID: 3025835.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Bjorklund K, Nordstrom ML, Bergstrom S. Sonographic assessment of symphyseal joint distention during pregnancy and post partum with special reference to pelvic pain. Acta Obstet Gynecol Scand. 1999;78(2):125–30. PubMed PMID: 10023875.

    CAS  PubMed  Google Scholar 

  71. Scriven MW, Jones DA, McKnight L. The importance of pubic pain following childbirth: a clinical and ultrasonographic study of diastasis of the pubic symphysis. J R Soc Med. 1995;88(1):28–30. PubMed PMID: 7884766. Pubmed Central PMCID: 1295070.

    CAS  PubMed  PubMed Central  Google Scholar 

  72. Kurzel RB, Au AH, Rooholamini SA, Smith W. Magnetic resonance imaging of peripartum rupture of the symphysis pubis. Obstet Gynecol. 1996;87(5 Pt 2):826–9. PubMed PMID: 8677103.

    CAS  PubMed  Google Scholar 

  73. Becker I, Woodley SJ, Stringer MD. The adult human pubic symphysis: a systematic review. J Anat. 2010;217(5):475–87. PubMed PMID: 20840351. Pubmed Central PMCID: 3035856.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Liaw LJ, Hsu MJ, Liao CF, Liu MF, Hsu AT. The relationships between inter-recti distance measured by ultrasound imaging and abdominal muscle function in postpartum women: a 6-month follow-up study. J Orthop Sports Phys Ther. 2011;41(6):435–43. PubMed PMID: 21289454.

    Article  PubMed  Google Scholar 

  75. Coldron Y, Stokes MJ, Newham DJ, Cook K. Postpartum characteristics of rectus abdominis on ultrasound imaging. Man Ther. 2008;13(2):112–21. PubMed PMID: 17208034.

    Article  PubMed  Google Scholar 

  76. Amorosa LF, Amorosa JH, Wellman DS, Lorich DG, Helfet DL. Management of pelvic injuries in pregnancy. Orthop Clin North Am. 2013;44(3):301–15, viii, PubMed PMID: 23827834.

    Article  PubMed  Google Scholar 

  77. Kharrazi FD, Rodgers WB, Kennedy JG, Lhowe DW. Parturition-induced pelvic dislocation: a report of four cases. J Orthop Trauma. 1997;11(4):277–81; discussion 81-2. PubMed PMID: 9258826.

    Article  CAS  PubMed  Google Scholar 

  78. Brennan D, O’Connell MJ, Ryan M, Cunningham P, Taylor D, Cronin C, et al. Secondary cleft sign as a marker of injury in athletes with groin pain: MR image appearance and interpretation. Radiology. 2005;235(1):162–7. PubMed PMID: 15731372.

    Article  PubMed  Google Scholar 

  79. Cunningham PM, Brennan D, O’Connell M, MacMahon P, O’Neill P, Eustace S. Patterns of bone and soft-tissue injury at the symphysis pubis in soccer players: observations at MRI. AJR Am J Roentgenol. 2007;188(3):W291–6. PubMed PMID: 17312039.

    Article  PubMed  Google Scholar 

  80. Robinson P, Barron DA, Parsons W, Grainger AJ, Schilders EM, O’Connor PJ. Adductor-related groin pain in athletes: correlation of MR imaging with clinical findings. Skeletal Radiol. 2004;33(8):451–7. PubMed PMID: 15224172.

    Article  CAS  PubMed  Google Scholar 

  81. Robinson P, Salehi F, Grainger A, Clemence M, Schilders E, O’Connor P, et al. Cadaveric and MRI study of the musculotendinous contributions to the capsule of the symphysis pubis. AJR Am J Roentgenol. 2007;188(5):W440–5. PubMed PMID: 17449740.

    Article  PubMed  Google Scholar 

  82. Shortt CP, Zoga AC, Kavanagh EC, Meyers WC. Anatomy, pathology, and MRI findings in the sports hernia. Semin Musculoskelet Radiol. 2008;12(1):54–61. PubMed PMID: 18382944.

    Article  PubMed  Google Scholar 

  83. Zoga AC, Kavanagh EC, Omar IM, Morrison WB, Koulouris G, Lopez H, et al. Athletic pubalgia and the “sports hernia”: MR imaging findings. Radiology. 2008;247(3):797–807. PubMed PMID: 18487535.

    Article  PubMed  Google Scholar 

  84. Fitzgerald CM, Plastaras C, Mallinson T. A retrospective study on the efficacy of pubic symphysis corticosteroid injections in the treatment of pubic symphysis pain. Pain Med. 2011;12(12):1831–5. PubMed PMID: 22082118.

    Article  PubMed  Google Scholar 

  85. Mehin R, Meek R, O’Brien P, Blachut P. Surgery for osteitis pubis. Can J Surg. 2006;49(3):170–6. PubMed PMID: 16749977. Pubmed Central PMCID: 3207605.

    PubMed  PubMed Central  Google Scholar 

  86. Garras DN, Carothers JT, Olson SA. Single-leg-stance (flamingo) radiographs to assess pelvic instability: how much motion is normal? J Bone Joint Surg Am. 2008;90(10):2114–8. PubMed PMID: 18829908.

    Article  PubMed  Google Scholar 

  87. Kunduracioglu B, Yilmaz C, Yorubulut M, Kudas S. Magnetic resonance findings of osteitis pubis. J Magn Reson Imaging. 2007;25(3):535–9. PubMed PMID: 17326088.

    Article  PubMed  Google Scholar 

  88. Verrall GM, Henry L, Fazzalari NL, Slavotinek JP, Oakeshott RD. Bone biopsy of the parasymphyseal pubic bone region in athletes with chronic groin injury demonstrates new woven bone formation consistent with a diagnosis of pubic bone stress injury. Am J Sports Med. 2008;36(12):2425–31. PubMed PMID: 18927251.

    Article  PubMed  Google Scholar 

  89. Budak MJ, Oliver TB. There’s a hole in my symphysis—a review of disorders causing widening, erosion, and destruction of the symphysis pubis. Clin Radiol. 2013;68(2):173–80. PubMed PMID: 22748520.

    Article  CAS  PubMed  Google Scholar 

  90. Major NM, Helms CA. Pelvic stress injuries: the relationship between osteitis pubis (symphysis pubis stress injury) and sacroiliac abnormalities in athletes. Skeletal Radiol. 1997;26(12):711–7. PubMed PMID: 9453104.

    Article  CAS  PubMed  Google Scholar 

  91. Choi H, McCartney M, Best TM. Treatment of osteitis pubis and osteomyelitis of the pubic symphysis in athletes: a systematic review. Br J Sports Med. 2011;45(1):57–64. PubMed PMID: 18812419. Pubmed Central PMCID: 3719975.

    Article  PubMed  Google Scholar 

  92. Kavroudakis E, Karampinas PK, Evangelopoulos DS, Vlamis J. Treatment of osteitis pubis in non-athlete female patients. Open Orthop J. 2011;5:331–4. PubMed PMID: 21966337. Pubmed Central PMCID: 3178876.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  93. Mitra R. Osteitis condensans ilii. Rheumatol Int. 2010;30(3):293–6. PubMed PMID: 19711079.

    Article  PubMed  Google Scholar 

  94. Jenks K, Meikle G, Gray A, Stebbings S. Osteitis condensans ilii: a significant association with sacroiliac joint tenderness in women. Int J Rheum Dis. 2009;12(1):39–43. PubMed PMID: 20374315.

    Article  PubMed  Google Scholar 

  95. Tuite MJ. Sacroiliac joint imaging. Semin Musculoskelet Radiol. 2008;12(1):72–82. PubMed PMID: 18382946.

    Article  PubMed  Google Scholar 

  96. Resnick D, Niwayama G, Goergen TG. Comparison of radiographic abnormalities of the sacroiliac joint in degenerative disease and ankylosing spondylitis. AJR Am J Roentgenol. 1977;128(2):189–96. PubMed PMID: 401599.

    Article  CAS  PubMed  Google Scholar 

  97. Ayoub MA. Refractory osteitis condensans ilii: outcome of a novel mini-invasive surgical approach. Int Orthop. 2013;37(7):1251–6. PubMed PMID: 23645082. Pubmed Central PMCID: 3685678.

    Article  PubMed  PubMed Central  Google Scholar 

  98. Vleeming A, Schuenke MD, Masi AT, Carreiro JE, Danneels L, Willard FH. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat. 2012;221(6):537–67. PubMed PMID: 22994881.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  99. Puhakka KB, Melsen F, Jurik AG, Boel LW, Vesterby A, Egund N. MR imaging of the normal sacroiliac joint with correlation to histology. Skeletal Radiol. 2004;33(1):15–28. PubMed PMID: 14614576.

    Article  CAS  PubMed  Google Scholar 

  100. Madsen KB, Schiottz-Christensen B, Jurik AG. Prognostic significance of magnetic resonance imaging changes of the sacroiliac joints in spondyloarthritis—a followup study. J Rheumatol. 2010;37(8):1718–27. PubMed PMID: 20516024.

    Article  PubMed  Google Scholar 

  101. Baker JF, McGuire CM, Mulhall KJ. Acetabular labral tears following pregnancy. Acta Orthop Belg. 2010;76(3):325–8. PubMed PMID: 20698452.

    PubMed  Google Scholar 

  102. Martinoli C, Garello I, Marchetti A, Palmieri F, Altafini L, Valle M, et al. Hip ultrasound. Eur J Radiol. 2012;81(12):3824–31. PubMed PMID: 21571471.

    Article  PubMed  Google Scholar 

  103. Klauser AS, Martinoli C, Tagliafico A, Bellmann-Weiler R, Feuchtner GM, Wick M, et al. Greater trochanteric pain syndrome. Semin Musculoskelet Radiol. 2013;17(1):43–8. PubMed PMID: 23487333.

    Article  PubMed  Google Scholar 

  104. Woon JT, Maigne JY, Perumal V, Stringer MD. Magnetic resonance imaging morphology and morphometry of the coccyx in coccydynia. Spine. 2013;38(23):E1437–45. PubMed PMID: 23917643.

    Article  PubMed  Google Scholar 

  105. Maigne JY, Rusakiewicz F, Diouf M. Postpartum coccydynia: a case series study of 57 women. Eur J Phys Rehabil Med. 2012;48(3):387–92. PubMed PMID: 22820826.

    PubMed  Google Scholar 

  106. Trouvin AP, Goeb V, Vandhuick T, Michelin P, Lequerre T, Vittecoq O. Role for magnetic resonance imaging in coccydynia with sacrococcygeal dislocation. Joint Bone Spine. 2013;80(2):214–6. PubMed PMID: 23098924.

    Article  PubMed  Google Scholar 

  107. Maigne JY, Pigeau I, Roger B. Magnetic resonance imaging findings in the painful adult coccyx. Eur Spine J. 2012;21(10):2097–104. PubMed PMID: 22354690. Pubmed Central PMCID: 3463700.

    Article  PubMed  PubMed Central  Google Scholar 

  108. Lechner M, Fortelny R, Ofner D, Mayer F. Suspected inguinal hernias in pregnancy-handle with care! Hernia. 2014;18(3):375–9. PubMed PMID: 23559310.

    Article  CAS  PubMed  Google Scholar 

  109. Polat AV, Aydin R, Polat AK, Kececi IS, Karahan G, Taskin GO. Round ligament varicosities: a rare cause of groin swelling in pregnancy. Abdom Imaging. 2013;38(5):1178–81. PubMed PMID: 23397551.

    Article  PubMed  Google Scholar 

  110. Buch KE, Tabrizian P, Divino CM. Management of hernias in pregnancy. J Am Coll Surg. 2008;207(4):539–42. PubMed PMID: 18926456.

    Article  PubMed  Google Scholar 

  111. Grant T, Neuschler E, Hartz 3rd W. Groin pain in women: use of sonography to detect occult hernias. J Ultrasound Med. 2011;30(12):1701–7. PubMed PMID: 22124006.

    Article  PubMed  Google Scholar 

  112. Pattamapaspong N, Sivasomboon C, Settakorn J, Pruksakorn D, Muttarak M. Pitfalls in imaging of musculoskeletal infections. Semin Musculoskelet Radiol. 2014;18(1):86–100. PubMed PMID: 24515885.

    Article  PubMed  Google Scholar 

  113. Soldatos T, Andreisek G, Thawait GK, Guggenberger R, Williams EH, Carrino JA, et al. High-resolution 3-T MR neurography of the lumbosacral plexus. Radiographics. 2013;33(4):967–87. PubMed PMID: 23842967.

    Article  PubMed  Google Scholar 

  114. Dunk RA, Langhoff-Roos J. Osteomyelitis of the pubic symphysis after spontaneous vaginal delivery. BMJ Case Rep. 2010;2010. PubMed PMID: 22789689. Pubmed Central PMCID: 3030074.

    Google Scholar 

  115. Lentz SS. Osteitis pubis: a review. Obstet Gynecol Surv. 1995;50(4):310–5. PubMed PMID: 7783998.

    Article  CAS  PubMed  Google Scholar 

  116. Ross JJ, Hu LT. Septic arthritis of the pubic symphysis: review of 100 cases. Medicine. 2003;82(5):340–5. PubMed PMID: 14530783.

    Article  PubMed  Google Scholar 

  117. Nelson DB, Manders DB, Shivvers SA. Primary iliopsoas abscess and pregnancy. Obstet Gynecol. 2010;116 Suppl 2:479–82. PubMed PMID: 20664425.

    Article  PubMed  Google Scholar 

  118. Sokolov KM, Kreye E, Miller LG, Choi C, Tang AW. Postpartum iliopsoas pyomyositis due to community-acquired methicillin-resistant Staphylococcus aureus. Obstet Gynecol. 2007;110(2 Pt 2):535–8. PubMed PMID: 17666656.

    Article  PubMed  Google Scholar 

  119. Young OM, Werner E, Sfakianaki AK. Primary psoas muscle abscess after an uncomplicated spontaneous vaginal delivery. Obstet Gynecol. 2010;116 Suppl 2:477–9. PubMed PMID: 20664424.

    Article  PubMed  Google Scholar 

  120. Liu XQ, Li FC, Wang JW, Wang S. Postpartum septic sacroiliitis misdiagnosed as sciatic neuropathy. Am J Med Sci. 2010;339(3):292–5. PubMed PMID: 20090512.

    Article  PubMed  Google Scholar 

  121. Mulvey JM. Postpartum septic sacroiliitis coincident with labour epidural analgesia. Anaesth Intensive Care. 2008;36(6):875–8. PubMed PMID: 19115661.

    Article  CAS  PubMed  Google Scholar 

  122. Hobson-Webb LD, Padua L, Martinoli C. Ultrasonography in the diagnosis of peripheral nerve disease. Expert Opin Med Diagn. 2012;6(5):457–71. PubMed PMID: 23480810.

    Article  PubMed  Google Scholar 

  123. Martinoli C, Gandolfo N, Perez MM, Klauser A, Palmieri F, Padua L, et al. Brachial plexus and nerves about the shoulder. Semin Musculoskelet Radiol. 2010;14(5):523–46. PubMed PMID: 21072730.

    Article  PubMed  Google Scholar 

  124. Chhabra A, Thawait GK, Soldatos T, Thakkar RS, Del Grande F, Chalian M, et al. High-resolution 3T MR neurography of the brachial plexus and its branches, with emphasis on 3D imaging. AJNR Am J Neuroradiol. 2013;34(3):486–97. PubMed PMID: 22976233.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  125. Padua L, Di Pasquale A, Liotta G, Granata G, Pazzaglia C, Erra C, et al. Ultrasound as a useful tool in the diagnosis and management of traumatic nerve lesions. Clin Neurophysiol. 2013;124(6):1237–43. PubMed PMID: 23380690.

    Article  CAS  PubMed  Google Scholar 

  126. Padua L, Liotta G, Di Pasquale A, Granata G, Pazzaglia C, Caliandro P, et al. Contribution of ultrasound in the assessment of nerve diseases. Eur J Neurol. 2012;19(1):47–54. PubMed PMID: 21554493.

    Article  CAS  PubMed  Google Scholar 

  127. Klauser AS, Faschingbauer R, Bauer T, Wick MC, Gabl M, Arora R, et al. Entrapment neuropathies II: carpal tunnel syndrome. Semin Musculoskelet Radiol. 2010;14(5):487–500. PubMed PMID: 21072727.

    Article  PubMed  Google Scholar 

  128. Tagliafico A, Bignotti B, Miguel Perez M, Reni L, Bodner G, Martinoli C. Contribution of ultrasound in the assessment of patients with suspect idiopathic pudendal nerve disease. Clin Neurophysiol. 2013;7. PubMed PMID: 24368033.

    Google Scholar 

  129. Martinoli C, Court-Payen M, Michaud J, Padua L, Altafini L, Marchetti A, et al. Imaging of neuropathies about the ankle and foot. Semin Musculoskelet Radiol. 2010;14(3):344–56. PubMed PMID: 20539959.

    Article  PubMed  Google Scholar 

  130. Kamath S, Venkatanarasimha N, Walsh MA, Hughes PM. MRI appearance of muscle denervation. Skeletal Radiol. 2008;37(5):397–404. PubMed PMID: 18360752.

    Article  CAS  PubMed  Google Scholar 

  131. Kim SJ, Hong SH, Jun WS, Choi JY, Myung JS, Jacobson JA, et al. MR imaging mapping of skeletal muscle denervation in entrapment and compressive neuropathies. Radiographics. 2011;31(2):319–32. PubMed PMID: 21415181.

    Article  PubMed  Google Scholar 

  132. Cartwright MS, Walker FO. Neuromuscular ultrasound in common entrapment neuropathies. Muscle Nerve. 2013;48(5):696–704. PubMed PMID: 23681885.

    Article  PubMed  Google Scholar 

  133. Fritz J, Chhabra A, Wang KC, Carrino JA. Magnetic resonance neurography-guided nerve blocks for the diagnosis and treatment of chronic pelvic pain syndrome. Neuroimaging Clin N Am. 2014;24(1):211–34. PubMed PMID: 24210321.

    Article  PubMed  Google Scholar 

  134. Klein A. Peripheral nerve disease in pregnancy. Clin Obstet Gynecol. 2013;56(2):382–8. PubMed PMID: 23563878.

    Article  PubMed  Google Scholar 

  135. Bradshaw AD, Advincula AP. Postoperative neuropathy in gynecologic surgery. Obstet Gynecol Clin North Am. 2010;37(3):451–9. PubMed PMID: 20674786.

    Article  PubMed  Google Scholar 

  136. Massey EW, Stolp KA. Peripheral neuropathy in pregnancy. Phys Med Rehabil Clin N Am. 2008;19(1):149–62, vii-viii. PubMed PMID: 18194755.

    Article  PubMed  Google Scholar 

  137. Osterman M, Ilyas AM, Matzon JL. Carpal tunnel syndrome in pregnancy. Orthop Clin North Am. 2012;43(4):515–20. PubMed PMID: 23026467.

    Article  PubMed  Google Scholar 

  138. Tagliafico A, Pugliese F, Bianchi S, Bodner G, Padua L, Rubino M, et al. High-resolution sonography of the palmar cutaneous branch of the median nerve. AJR Am J Roentgenol. 2008;191(1):107–14. PubMed PMID: 18562732.

    Article  PubMed  Google Scholar 

  139. Anderson SE, Steinbach LS, De Monaco D, Bonel HM, Hurtienne Y, Voegelin E. “Baby wrist”: MRI of an overuse syndrome in mothers. AJR Am J Roentgenol. 2004;182(3):719–24. PubMed PMID: 14975975.

    Article  PubMed  Google Scholar 

  140. Beltran LS, Bencardino J, Ghazikhanian V, Beltran J. Entrapment neuropathies III: lower limb. Semin Musculoskelet Radiol. 2010;14(5):501–11. PubMed PMID: 21072728.

    Article  PubMed  Google Scholar 

  141. Martinoli C, Miguel-Perez M, Padua L, Gandolfo N, Zicca A, Tagliafico A. Imaging of neuropathies about the hip. Eur J Radiol. 2013;82(1):17–26. PubMed PMID: 21549536.

    Article  PubMed  Google Scholar 

  142. Tagliafico A, Serafini G, Lacelli F, Perrone N, Valsania V, Martinoli C. Ultrasound-guided treatment of meralgia paresthetica (lateral femoral cutaneous neuropathy): technical description and results of treatment in 20 consecutive patients. J Ultrasound Med. 2011;30(10):1341–6. PubMed PMID: 21968484.

    Article  PubMed  Google Scholar 

  143. Chhabra A, Del Grande F, Soldatos T, Chalian M, Belzberg AJ, Williams EH, et al. Meralgia paresthetica: 3-tesla magnetic resonance neurography. Skeletal Radiol. 2013;42(6):803–8. PubMed PMID: 23306718.

    Article  PubMed  Google Scholar 

  144. Moritz T, Prosch H, Berzaczy D, Happak W, Lieba-Samal D, Bernathova M, et al. Common anatomical variation in patients with idiopathic meralgia paresthetica: a high resolution ultrasound case-control study. Pain Physician. 2013;16(3):E287–93. PubMed PMID: 23703427.

    Article  PubMed  Google Scholar 

  145. Mulvaney SW. Ultrasound-guided percutaneous neuroplasty of the lateral femoral cutaneous nerve for the treatment of meralgia paresthetica: a case report and description of a new ultrasound-guided technique. Curr Sports Med Rep. 2011;10(2):99–104. PubMed PMID: 21623291.

    Article  PubMed  Google Scholar 

  146. Butchart AG, Mathews M, Surendran A. Complex regional pain syndrome following protracted labour*. Anaesthesia. 2012;67(11):1272–4. PubMed PMID: 22881282.

    Article  CAS  PubMed  Google Scholar 

  147. Hong BY, Ko YJ, Kim HW, Lim SH, Cho YR, Lee JI. Intrapartum obturator neuropathy diagnosed after cesarean delivery. Arch Gynecol Obstet. 2010;282(3):349–50. PubMed PMID: 20306064.

    Article  PubMed  Google Scholar 

  148. Nogajski JH, Shnier RC, Zagami AS. Postpartum obturator neuropathy. Neurology. 2004;63(12):2450–1. PubMed PMID: 15623734.

    Article  CAS  PubMed  Google Scholar 

  149. Soldatos T, Durand DJ, Subhawong TK, Carrino JA, Chhabra A. Magnetic resonance imaging of musculoskeletal infections: systematic diagnostic assessment and key points. Acad Radiol. 2012;19(11):1434–43. PubMed PMID: 22884398.

    Article  PubMed  Google Scholar 

  150. Tagliafico A, Succio G, Serafini G, Martinoli C. Diagnostic accuracy of MRI in adults with suspect brachial plexus lesions: a multicentre retrospective study with surgical findings and clinical follow-up as reference standard. Eur J Radiol. 2012;81(10):2666–72. PubMed PMID: 22071340.

    Article  PubMed  Google Scholar 

  151. Tagliafico A, Succio G, Serafini G, Martinoli C. Diagnostic performance of ultrasound in patients with suspected brachial plexus lesions in adults: a multicenter retrospective study with MRI, surgical findings and clinical follow-up as reference standard. Skeletal Radiol. 2013;42(3):371–6. PubMed PMID: 22707095.

    Article  PubMed  Google Scholar 

  152. Tagliafico A, Perez MM, Martinoli C. High-resolution ultrasound of the pudendal nerve: normal anatomy. Muscle Nerve. 2013;47(3):403–8. PubMed PMID: 23180573.

    Article  PubMed  Google Scholar 

  153. Fanucci E, Manenti G, Ursone A, Fusco N, Mylonakou I, D’Urso S, et al. Role of interventional radiology in pudendal neuralgia: a description of techniques and review of the literature. Radiol Med. 2009;114(3):425–36. PubMed PMID: 19277838.

    Article  CAS  PubMed  Google Scholar 

  154. Thoumas D, Leroi AM, Mauillon J, Muller JM, Benozio M, Denis P, et al. Pudendal neuralgia: CT-guided pudendal nerve block technique. Abdom Imaging. 1999;24(3):309–12. PubMed PMID: 10227901.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

Dr. Megan Schimpf, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI and Dr. David Jamadar, Department of Radiology, University of Michigan and Veterans Affairs Medical Center, Ann Arbor, MI for their reading of the manuscript.

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  1. Department of Radiology, University of Michigan, 1500 E Medical Center Drive, SPC 5326, Taubman Center, Room 2910D, Ann Arbor, MI, 48109-5326, USA

    Catherine J. Brandon MD, MS

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  1. Catherine J. Brandon MD, MS
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Correspondence to Catherine J. Brandon MD, MS .

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  1. Department of Obstetrics & Gynecology, Loyola University, Maywood, Illinois, USA

    Colleen M. Fitzgerald

  2. Department of Rehabilitation Medicine, University of Kansas, Kansas City, Kansas, USA

    Neil A. Segal

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Brandon, C.J. (2015). Musculoskeletal Imaging in the Pregnant and Postpartum Patient. In: Fitzgerald, C., Segal, N. (eds) Musculoskeletal Health in Pregnancy and Postpartum. Springer, Cham. https://doi.org/10.1007/978-3-319-14319-4_3

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