Postpartum pelvic pain--the "pelvic joint syndrome": a follow-up study with special reference to diagnostic methods

The etiology of pelvic joint syndrome (PJS) is not fully clarified. As a consequence, there is a lack of diagnostic methods to confirm the diagnosis, which today is mainly based on medical history.

The aim of this study was to examine women with PJS using various diagnostic methods. The hypothesis is that there are characteristics in this group of women that separate them from women who only suffer from pelvic pain during pregnancy and shortly after delivery, or healthy women.

Fifty-eight women participated in this follow-up study--twenty-one with PJS, 17 women who suffered from pelvic pain during pregnancy and shortly after delivery, and 20 controls with no history of pregnancy-induced pelvic pain. Clinical examination, gynecologic examination, psychological tests, spine X-ray, magnetic resonance imaging (MRI), blood samples, and urine dipsticks were performed.

Clinical examination showed significant differences with regard to provocative tests and tenderness in the muscles and ligaments in the low back and the pelvis. Furthermore, psychological testing showed bad coping strategies when women with PJS were compared with those of the two control groups. However, no diagnostic method could explicitly differentiate between women with PJS and those of the two control groups. Thus, there was no significant difference in MRI, X-ray, blood or urine sample analysis.

Women with PJS have positive provocative tests and ligament and muscular tenderness. Bad coping strategies might be an explanation why these women develop PJS.