Aims and objectives
It is estimated that almost half of women experience some degree of musculoskeletal discomfort during pregnancy.
Familiarity with the range of musculoskeletal pathologies on MR imaging studies which are encountered in the peri-partum patient is crucial.
Here we present a series of cases in which MRI was central to the diagnosis of musculoskeletal pathologies at our institution.
We aim to review imaging findings of both the common and rare pregnancy-related musculoskeletal conditions.
Methods and materials
A retrospective review was performed of MRI imaging undertaken of patients during pregnancy or the peri-partum period.
The study included patients who underwent MRI imaging over a period of 9 years (Jan 2008 to Dec 2016 inclusive).
A review of computerised medical records provided demographical information,
information relating to the pregnancy as well as follow up care where available.
The imaging was retrospectively re-assessed for the additional presence of musculoskeletal pathology.
Results
A total of 77 studieswere included.
51 were performed during pregnancy and 26 during the post partum period.
The average patient age was 34.
29.9% of patients had musculoskeletal findings.
Focusing on the prepartum group,
the average weeks gestation was 26.9,
ranging from 9 to 40 weeks.
Musculosketetal pathology was found in 10 studies(22%).
Findings can be divided into those relating directly to pregnancy – pubic symphysis oedema in 4 patients,
oedema of the sacroiliac joints in 2 patients and ps diasthesis in one patient....
Conclusion
Pregnancy is a physiologic process but with potential for significatnt morbidity.
Musculoskeletal morbidity is a facet of childbearign that is likely underestimated.
Here,
we show that musculoskeletal findings on MRI are reasonable common in the peripartum period,
particularly in the post partum period.
We also found that musculoskeletal morbidity affected a very substantial portion of pateints who underwent a vaginal delivery,
as compared to those who underwent caesarean section where no pateints in our study cohort were found to have pathologies realting to the musculoskeletal...
References
1.
Wu WH,
Meijer OG,
Uegaki K,
et al.
Pregnancy – related pelvic girdle pain (PPP).
I.
Terminology,
clinical presentation,
and prevalance.
Eur Spine J 2004; 13:575 - 589.