Muscles and Pelvic Gears: Hip Abductor Inhibition in Anterior Rotation of the Ilium

Abstract

Background

The nerve irritation syndrome caused by a dysfunction of the thoracic spine and the thoraco-lumbar junction is a typical example of pain referred around the chest and of the abdominal wall simulating the pain of visceral disease.

Methods

The authors have recorded the distribution and extent of skin roll tenderness in the lower back, in the abdominal wall and in the lower limb in 337 consecutive patients with clinical signs of segmental inter-vertebral dysfunction of the thoracic spine and thoraco-lumbar junction.

Results

The authors have shown four different skin area patterns:

1	Horizontal area in the chest or in the abdominal wall and diagonal area in the mid-back; this pattern was very frequent and was consequent on the involvement of the mid-thoracic level.
2	Horizontal area in the chest or in the abdominal wall and an oval area in the buttock; this pattern was not very frequent and was consequent on the involvement of the mid-thoracic level.
3	Solid sheet area reaching from the trochanteric zone over the groin and pubes and often as far as the upper and medial thigh zone; this pattern was very frequent and consequent on the involvement of the thoraco-lumbar junction level.
4	Mixed pattern between 1 and 4 patterns; this pattern was very infrequent and was consequent on the involvement of the low-thoracic level.

In patterns 3 and 4, the size of the solid sheet area reaching from the trochanteric as far as the upper and medial thigh zone was very variable.

Conclusions

Our observations have some important implications for treatment. Recognition of the clinical patterns and careful clinical examination permit early diagnosis and appropriate treatment, and can spare patients the risk of undergoing some invasive diagnostic and therapeutic procedures.