Reversible Pelvic Asymmetry: An Overlooked Syndrome Manifesting as Scoliosis, Apparent Leg-Length Difference, and Neurologic Symptoms
Received 24 October 2005; received in revised form 28 February 2006; accepted 26 April 2006.
Abstract
Objective
The objective of this study was to investigate the occurrence of pelvic asymmetry in neurologic patients with symptoms not explained by their neurologic diagnosis.
Methods
We analyzed 150 consecutive neurologic patients referred to physiatric consultation based on their clinical examination findings.
Results
We observed pelvic asymmetry associated with either C-type or S-type scoliosis and apparent leg-length difference in 87% of the patients. Symmetry could be reestablished by all patients, although 15% showed immediate or imminent relapse. Maintenance of symmetry showed a highly significant (P < .001) correlation with improvement in functional ability and reduction of pain as evaluated during the last visit to the physiatrist. In the follow-up questionnaire, 78% of the patients reported improvement in functional ability and reduced pain.
Conclusions
Our results support the view that leg-length difference and scoliosis may be more often of reversible nature than previously considered. Acquired postural asymmetry of the sacroiliac joint may be a neglected cause of several neurologic and other pain-related symptoms that can be relieved by a simple and safe treatment.
aPhysiatrist, Unit of Physiatry, Helsinki University Central Hospital, Helsinki, Finland
bProfessor of Neurology, Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
Submit requests for reprints to: Jussi Timgren, MD, Physiatrist, Unit of Physiatry, Helsinki University Central Hospital, PO Box 340, Helsinki 00029, Finland.
ABSTRACT