Life University

Gonstead Study Club

Pelvis
Directions of Ilium Misalignment
 The basic directions that the ilium can become misaligned with the
sacrum

 Anterioward
 Posteriorward
 Medialward
 Lateralward

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Where the Misalignment Occurs
 Occurs in the sacroiliac articulation
 Tendency to think subluxations occur at the hip joint

 Emphasis is placed on the Ilium

 An AS/PI misaligned ilium travels in an arc due to:

 Nature of the auricular surfaces of the joint
 Angle of the pelvis itself

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Changes Accompanying the AS and PI Ilium
 AS Ilium  PI Ilium
 ↓ in innominate  ↑ in innominate
measurement measurement
 ↓ diagonal length of obturator  ↑ diagonal length of obturator
 ↓ lumbar curve  ↑ lumbar curve
 Lowers femur head height  Raises femur head height
 Edematous joint space opens at  Edematous joint space opens at
posterior-inferior and anterior- posterior-superior and anterior-
superior margins inferior margins
 Leaves sacrum posterior in  Leaves sacrum anterior in relation
relation to the ilium to the ilium

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Measurement of an AS Misalignment

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Measurement of a PI Misalignment

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Changes Accompanying the AS and PI Ilium
 AS Ilium  PI Ilium
 ↓ in innominate measurement  ↑ in innominate measurement
 ↓ diagonal length of  ↑ diagonal length of
obturator obturator
 ↓ lumbar curve  ↑ lumbar curve
 Lowers femur head height  Raises femur head height
 Edematous joint space opens at  Edematous joint space opens at
posterior-inferior and anterior- posterior-superior and anterior-
superior margins inferior margins
 Leaves sacrum posterior in  Leaves sacrum anterior in relation
relation to the ilium to the ilium

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Normal Obturator Appearance

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Obturator Appearance in PI/AS Misalignment

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Changes Accompanying the AS and PI Ilium
 AS Ilium
 ↓ in innominate measurement
 ↓ diagonal length of obturator
 ↓ lumbar curve
 Lowers femur head height
 Edematous joint space opens at
posterior-inferior and anterior-
superior margins
 Leaves sacrum posterior in
relation to the ilium
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 PI Ilium
 ↑ in innominate measurement
 ↑ diagonal length of obturator
 ↑ lumbar curve
 Raises femur head height
 Edematous joint space opens at
posterior-superior and anterior-
inferior margins
 Leaves sacrum anterior in relation
to the ilium
Lumbar Curve Changes

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Changes Accompanying the AS and PI Ilium
 AS Ilium
 ↓ in innominate measurement
 ↓ diagonal length of obturator
 ↓ lumbar curve
 Lowers femur head height
 Edematous joint space opens at
posterior-inferior and anterior-
superior margins
 Leaves sacrum posterior in
relation to the ilium
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 PI Ilium
 ↑ in innominate measurement
 ↑ diagonal length of obturator
 ↑ lumbar curve
 Raises femur head height
 Edematous joint space opens at
posterior-superior and anterior-
inferior margins
 Leaves sacrum anterior in relation
to the ilium
Femur Head Height Changes

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AS Ilium Raising Femur Head

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PI Ilium Raising Femur Head

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Changes Accompanying the AS and PI Ilium
 AS Ilium  PI Ilium
 ↓ in innominate measurement  ↑ in innominate measurement
 ↓ diagonal length of obturator  ↑ diagonal length of obturator
 ↓ lumbar curve  ↑ lumbar curve
 Lowers femur head height  Raises femur head height
 Edematous joint space  Edematous joint space
opens at posterior-inferior opens at posterior-superior
and anterior-superior and anterior-inferior
margins margins
 Leaves sacrum posterior in  Leaves sacrum anterior in relation
relation to the ilium to the ilium

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Area of the Spongy Disc in AS & PI Ilium

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Changes Accompanying the AS and PI Ilium
 AS Ilium
 ↓ in innominate measurement
 ↓ diagonal length of obturator
 ↓ lumbar curve
 Lowers femur head height
 Edematous joint space opens at
posterior-inferior and anterior-
superior margins
 Leaves sacrum posterior in
relation to the ilium
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 PI Ilium
 ↑ in innominate measurement
 ↑ diagonal length of obturator
 ↑ lumbar curve
 Raises femur head height
 Edematous joint space opens at
posterior-superior and anterior-
inferior margins
 Leaves sacrum anterior in
relation to the ilium
Mechanism of In/Ex Ilium

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Changes Accompanying the In and Ex Ilium
 In Ilium  Ex Ilium
 ↑ in width  ↓ in width
 ↓ in width at the base of obturator  ↑ in width at the base of obturator
 ↓ lumbar curve  ↑ lumbar curve
 Edematous joint space opens at  Edematous joint space opens at
entire anterior margin entire posterior margin
 Raises the femur head height  Lowers the femur head height
 Foot will diverge further away from  Foot will converge toward the
the median line median line

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Ilium Width Changes

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Changes Accompanying the In and Ex Ilium
 In Ilium  Ex Ilium
 ↑ in width  ↓ in width
 ↓ in width at the base of  ↑ in width at the base of
obturator obturator
 ↓ lumbar curve  ↑ lumbar curve
 Edematous joint space opens at  Edematous joint space opens at
entire anterior margin entire posterior margin
 Raises the femur head height  Lowers the femur head height
 Foot will diverge further away from  Foot will converge toward the
the median line median line

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Normal Obturator Appearance

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Obturator Appearance in In/Ex Misalignment

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Changes Accompanying the In and Ex Ilium
 In Ilium  Ex Ilium
 ↑ in width  ↓ in width
 ↓ in width at the base of obturator  ↑ in width at the base of obturator
 ↓ lumbar curve  ↑ lumbar curve
 Edematous joint space opens at  Edematous joint space opens at
entire anterior margin entire posterior margin
 Raises the femur head height  Lowers the femur head height
 Foot will diverge further away from  Foot will converge toward the
the median line median line

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Lumbar Curve Changes

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Life University Gonstead Study Club
Changes Accompanying the In and Ex Ilium
 In Ilium  Ex Ilium
 ↑ in width  ↓ in width
 ↓ in width at the base of obturator  ↑ in width at the base of obturator
 ↓ lumbar curve  ↑ lumbar curve
 Edematous joint space  Edematous joint space
opens at entire anterior opens at entire posterior
margin margin
 Raises the femur head height  Lowers the femur head height
 Foot will diverge further away from  Foot will converge toward the
the median line median line

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Life University Gonstead Study Club
Changes Accompanying the In and Ex Ilium
 In Ilium  Ex Ilium
 ↑ in width  ↓ in width
 ↓ in width at the base of obturator  ↑ in width at the base of obturator
 ↓ lumbar curve  ↑ lumbar curve
 Edematous joint space opens at  Edematous joint space opens at
entire anterior margin entire posterior margin
 Raises the femur head  Lowers the femur head
height height
 Foot will diverge further away from  Foot will converge toward the
the median line median line

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In Ilium Raising Femur Head

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Ex Ilium Lowering Femur Head

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Life University Gonstead Study Club
Changes Accompanying the In and Ex Ilium
 In Ilium  Ex Ilium
 ↑ in width  ↓ in width
 ↓ in width at the base of obturator  ↑ in width at the base of obturator
 ↓ lumbar curve  ↑ lumbar curve
 Edematous joint space opens at  Edematous joint space opens at
entire anterior margin entire posterior margin
 Raises the femur head height  Lowers the femur head height
 Foot will diverge further  Foot will converge toward
away from the median line the median line

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A-P Film Marking Procedure

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A-P Film Marking Procedure

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Life University Gonstead Study Club
A-P Film Marking Procedure

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Life University Gonstead Study Club
A-P Film Marking Procedure

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Life University Gonstead Study Club