20 Questions
Which symptom is most commonly associated with endometrial cancer?
Post-menopausal bleeding
What is a significant risk factor for ovarian cancer?
Family history of ovarian cancer
Which factor is a known risk for cervical cancer?
Early age at first sexual intercourse
What is a common symptom of gastrointestinal causes of pelvic pain?
Blood in the stool
Which condition is a likely cause of anterior pelvic pain in women?
Femoral hernia
What is a potential cause of lower quadrant pain in the male reproductive system?
Prostate cancer
What is a characteristic of hip arthroplasty that may indicate component loosening?
Start up pain followed by relief and increasing pain with longer distances
What is a potential cause of sciatic neuropathy?
Spinal involvement
What are the systemic diseases that can refer pain to the sacrum?
Infection, Endocarditis, Rheumatic diseases, GI disorders
What are the clusters of signs and symptoms that should be carefully evaluated in lower back pain?
Clusters of S & S, Presence or absence of red flags, Dermatomal pattern, Radiating leg pain
Which of the following is a clinical sign of sacroiliac (SI) joint problem?
Thigh pain
What should be considered in the clinical decision tool for ruling out spine tumor?
Age > 50 years, No recent weight loss, No h/o CA, Responding to conservative treatment
Which test is NOT included in the SI joint test cluster?
Kernig's test
What is a characteristic of lumbar stenosis?
Radiating leg pain when standing or walking, Pain decreases or absent when sitting because pt prefers flexion, Improvement of symptoms with forward flexion, Wide based gait
Which condition is NOT mentioned as a medical cause of SI and sacral pain?
Rheumatoid arthritis
What should be considered when screening the Sacrum SI joint?
History is very important, Systemic diseases that refer pain to the sacrum, Vascular disorders, Precipitating event
What can result in sacral fractures?
Pathologic causes
What can SI joint pain mimic?
Pain referred from Lumbar disc herniation, Spinal stenosis, Facet joint dysfunction, Hip
Which conditions are mentioned as tumors affecting the sacrum?
Metastatic, secondary malignant
What can cause coccyodynia, or tailbone pain?
Pilonidal cyst
Study Notes
Pelvic Pain Assessment and Differential Diagnosis
- Clinical signs of sacroiliac (SI) joint problem include back pain, buttock pain, thigh pain, and "sciatic-like pain".
- SI joint test cluster includes positive distraction, compression, sacral spring, thigh thrust, and Gaenslen test.
- Medical causes of SI and sacral pain include metabolic bone diseases like osteoporosis, osteodystrophy, and Paget's disease.
- Sacral fractures can result from trauma-related, insufficiency, or pathologic causes.
- Tumors affecting the sacrum include benign, primary malignant, and metastatic types, with symptoms like lower back pain and leg radiating pain.
- GI causes of sacral pain can stem from conditions like ulcerative colitis, Crohn’s disease, and colon cancer.
- Coccyodynia, or tailbone pain, may be caused by trauma, childbirth, or conditions like pilonidal cyst.
- Pelvic pain can originate from musculoskeletal, neuromuscular, gynecological, infectious, vascular, cancer, or GI causes.
- Neuromuscular and musculoskeletal causes of pelvic pain can be aggravated by exercise and relieved by rest or stretching.
- Gynecological causes of pelvic pain include pregnancy, ectopic pregnancy, endometriosis, pelvic inflammatory disease (PID), prolapsed conditions, and cancer.
- Ectopic pregnancy is a medical emergency with symptoms such as unexplained vaginal bleeding, sudden lower abdominal pain, and hypotension.
- Prolapsed conditions like uterine prolapse, cystocele, rectocele, and enterocele can cause pelvic discomfort, urinary incontinence, and difficulty with defecation.
Test your knowledge of pelvic pain assessment and differential diagnosis with this quiz. Explore the clinical signs, medical causes, and differential diagnoses of pelvic pain, including musculoskeletal, gynecological, GI, and neuromuscular origins.
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