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Predictability of sacral base levelness based on iliac crest measurements
1Department of Manipulative Medicine, University of North Texas Health Science Center at Fort Worth/Texas College of Osteopathic Medicine 76107.
Summary
Palpating for leg length discrepancy is unreliable. Radiographic studies show iliac crest height poorly predicts sacral base position, especially in mild to moderate short leg syndromes.
Area of Science:
- Orthopedics
- Biomechanics
- Radiology
Background:
- Palpatory examinations are commonly used to assess leg length discrepancy and pelvic obliquity.
- These methods assume a direct relationship between pelvic bones and the sacral base.
- Radiographic techniques offer improved accuracy and consistency for these assessments.
Purpose of the Study:
- To evaluate the relationship between iliac crest levelness and sacral base levelness.
- To determine the reliability of iliac crest height as a predictor of sacral base position.
- To assess the accuracy of palpatory methods in diagnosing pelvic obliquity.
Main Methods:
- A radiographic postural survey was conducted on 358 individuals with suspected pelvic obliquity.
- Subjects were in an upright, weight-bearing position.
- Measurements of iliac crest height and sacral base levelness were analyzed.
Main Results:
- 293 subjects (81.8%) showed unlevel iliac crests or sacral bases.
- Iliac crest height predicted sacral base position with 62% accuracy for discrepancies >= 3/16 inch.
- Predictive accuracy improved to 83% for discrepancies >= 1/2 inch.
Conclusions:
- There is a significant difference between iliac crest heights and sacral base position.
- Iliac crest height is an unreliable predictor of sacral base levelness in mild to moderate short leg syndromes.
- Palpatory assessments for pelvic obliquity may lack diagnostic precision.