The sonoanatomy of lumbar erector spinae and its iliac attachment – the potential substrate of the iliac crest pain syndrome, an ultrasound study in healthy subjects
Background: Iliac crest pain syndrome is a regional pain syndrome that has been identified in many patients with low back pain. Based on anatomical studies, it was suggested that the potential substrate of this syndrome might be the enthesis of the erector spinae muscle at the posterior medial il...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sciendo
2018-03-01
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| Series: | Journal of Ultrasonography |
| Subjects: | |
| Online Access: | http://jultrason.pl/index.php/issues/volume-18-no-72/the-sonoanatomy-of-lumbar-erector-spinae-and-its-iliac-attachment-the-potential-substrate-of-the-iliac-crest-pain-syndrome-an-ultrasound-study-in-healthy-subjects?aid=580 |
| Summary: | Background: Iliac crest pain syndrome is a regional pain syndrome that has been identified
in many patients with low back pain. Based on anatomical studies, it was suggested
that the potential substrate of this syndrome might be the enthesis of the erector spinae
muscle at the posterior medial iliac crest. As there have been no imaging studies of this important
enthesis, our aim was to assess its characteristics by ultrasound. Methods: Erector
spinae enthesis was first studied in a cadaver. Then its characteristics were recorded in 25
healthy volunteers (median age: 28.92, SD: 5.31, mean Body Mass Index 22.61, SD: 3.38),
with Esaote My Lab 7 machine using linear transducer (4–13 MHz). Results: The cadaver
study confirmed the attachment of a substantial part of erector spinae to a well-defined
region on the medial posterior iliac crest. The US study in the volunteers consistently
showed the entheses as typical hyperechoic fibrillar structures, slightly oblique to the skin
in the longitudinal plane and attaching to the iliac crest. In the transverse plane, the entheses
were seen as oval, densely dotted structures in contact with the superior edge of posterior
superior iliac spine. Their mean thickness (4.9 ± 0.6 and 5.2 ± 0.7 mm longitudinally;
4.3 ± 0.6 and 4.4 ± 0.7 mm transversely), maximum width (16.3 ± 2.8 and 15.7 ± 2.3 mm)
and depth (10.8 ± 7.3 and 10.6 ± 6.2 mm) on the left and right side, respectively, as well
as their echostructure were recorded and described. Conclusions: The erector spinae entheses
could be assessed in detail by ultrasound, thus their pathological transformation
associated with iliac crest pain syndrome could be identified. |
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| ISSN: | 2084-8404 2451-070X |