The term "pelvic girdle relaxation" may be used if other ligaments in the pelvic girdle also show significant separation.
Clinical findings:
(1) The time of separation may be occult or it may with present as a crackling noise or a bursting sensation.
(2) The woman experiences pain in the region of the symphysis with point tenderness to palpation.
(3) Walking worsens the pain and the patient may develop a waddling gait.
(4) Back pain may develop or worsen if the separation is wide.
(5) Bruising, edema or a hematoma may be seen over the symphysis.
(6) Intercourse may be painful or uncomfortable.
(7) Pain may recur during ovulation.
(8) The condition usually resolves. The time may range from a few days in mild cases to 6-8 months when severe.
(9) The separation may recur on subsequent pregnancies.
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Separation of the Symphysis Pubis
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Interpretation
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4-5 mm
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normal distance in nonpregnant woman
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7-8 mm
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distance common in pregnant women
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8 - 9 mm
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indeterminate
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>= 1 cm
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abnormal separation
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If there is a family history of the condition and the patient shows joint laxity then Ehlers-Danlos or other inherited disorder of connective tissue should be considered.
Complications:
(1) Deep vein thrombosis may develop if the patient undergoes prolonged bedrest.
(2) Urinary and/or fecal incontinence may occur if a large hematoma forms.
The differential diagnosis is extensive and includes:
(1) osteomyelitis
(2) scoliosis
(3) rheumatologic disorder
(4) pelvic fracture
(5) herniated intervertebral disc
(6) bone tumor
(7) injury to the urinary bladder
