Date: Fri, 14 Mar 2003 14:27:43 +0100
Subject: Late ischial pain after pelvic fracture
From: Dr. Josep M. Muñoz Vives
50 yo male that suffered a RTA 14 years ago. He substained a femoral and pelvic fracture.
He works as a clerkman and complains of right isquiatic pain whenever he sits or walks for more than 1 hour.
Physical examination reveals no pelvic instability. Palpation of the isquion is painful. When he sits his pelvis tilts towards the left side.
MRI reveals no sign of bursitis.
How would you manage this patient.
Dr. Josep M. Muñoz Vives
Hospital Universitari Dr. Josep Trueta.
Date: Tue, 18 Mar 2003 19:26:42 -0500
From: Fred Barrick
He has a classic "weaver's bottom" problem from sitting on one ischium at all times. I am not sure that an MRI should be expected to show anything. I recommend a cushion that takes the weight off the right ishium and distributes to the left ishium and both thighs. I used a Roho quad cushion. in which one fourth can be deflated to distribute the weight to the other three sections.
Fred Barrick, MD
Director of Orthopaedic Trauma
Inova Fairfax Hospital
Falls Church, VA 22042