sacroiliac fascia fat hernia
Introduction
Introduction of iliac fascia fat Sacro-illacfacial lipocele refers to a kind of sputum formed by the protrusion of the buttocks through the tendon fascia, which is one of the causes of low back pain. There are many women, especially obese adult women, and men are relatively rare. The most typical sign of ankle fat sputum is the medial aspect of the upper iliac crest. The subcutaneous tissue above the ankle joint can reach multiple nodular masses ranging from 1 to 3 cm in diameter, and the nodular texture is hard and tough. Pain occurs when plucking or pressing. Some patients have lumbosacral lumps at the acupressure nodules, buttocks or ipsilateral thighs. The nodules can be round, elliptical or irregular, and can be fused individually or in multiple together. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific people Mode of infection: non-infectious complication:
Cause
Causes of iliac fascia fat sputum
Self-factor (45%):
The tendon fascia above the ankle joint is relatively weak, and the gluteal epithelial nerve and the accompanying vascular bundle, which are grouped by the lumbar 1-3 nerves, form an intrinsic pore when passing through the temporal fascia above the ankle joint. Locally, there is a relatively rich adipose tissue, especially obese women. When severe bending exercises or gluteus maximus contraction, the pressure of deep adipose tissue is increased, and the weak intrinsic pores are ejected or the fascia is torn and then formed. Fat sputum, edema of fat, bleeding, twisting, incarceration or compression of nearby cutaneous nerves can cause localized pain and induced pain in the distribution of the anterior branch of the lumbar nerve in the corresponding segment.
Other factors (40%):
The tendon fascia above the ankle joint has inherent pores, which is the pathological basis of the disease. In the case of strenuous exercise, the increase of deep adipose tissue pressure is the cause of the disease.
Pathogenesis
Because the size of the pupil is different from the content of the sputum, the pain and the nature are different. The time of onset is short, and the content of the sputum is small, and the content of the adipose tissue can be self-retained. Otherwise, the adipose tissue and the surrounding tissue are difficult to reconcile, forming a local painful nodule. At this time, the pain is obvious, and the symptoms of chronic low back and leg pain often occur. In addition, those who are born from the intrinsic hole have a heavier pain due to nerves and blood vessels, and the pain from the non-inherent pores is less severe.
Prevention
Sacral fascia fat sputum prevention
When there are inherent pores in the fascia fascia above the ankle joint, avoid vigorous exercise. The iliac fascia above the ankle joint has inherent pores, which is the pathological basis of the disease. The cause of the disease is not clear at present, so there is no way to prevent it directly. Early detection, early diagnosis, and early treatment are important for indirect prevention of this disease. Once the diagnosis is confirmed, the method can be performed. If the reset is unsuccessful or the condition is repeated, surgery can be performed to avoid tissue necrosis caused by incarceration of the hernia sac.
Complication
Acoustic fascia fat complication Complication
The most common incarceration of the hernia sac. Under normal circumstances, the contents of the sputum (usually the intestine) can enter the sac through the ankle ring under the pressure of the abdominal cavity, and can return to the abdominal cavity by itself (or by external force). Inside. When various reasons (such as friction, adhesion, etc.) make the content of the reversible sputum suddenly unable to return, when the local lumps increase, it indicates that the incarceration is concurrent, which is called incarcerated sputum. Blood necrosis, it should be vigilant.
Symptom
Symptoms of sacral fascia fat sputum Common symptoms Pain after knee pain,... Hip pain, sciatica, severe exercise, low back pain, lumbar vertebrae
Pain: The main symptoms are low back pain and pain in the affected side of the hip. Some patients have inductive sciatica. The degree of difference is large. Most of them are soreness and pain. A few are bent, squat, get up or crotch, and the waist is twisted. The pain suddenly increased, and even turned over, and activities such as getting up were limited.
The most typical sign of ankle fat sputum is the medial aspect of the upper iliac crest. The subcutaneous tissue above the ankle joint can reach multiple nodular masses ranging from 1 to 3 cm in diameter, and the nodular texture is hard and tough. Pain occurs when plucking or pressing. Some patients have lumbosacral lumps at the acupressure nodules, buttocks or ipsilateral thighs. The nodules can be round, elliptical or irregular, and can be fused individually or in multiple Together, some patients may have pain in the sciatic nerve distribution area, but the straight leg elevation test and the boost test are negative, and there is no lower limb sensory disturbance and abnormal reflection.
Examine
Examination of iliac fascia fat sputum
Imaging examination: X-ray, CT can identify lumbar disc herniation, spinal stenosis, lumbar spondylolisthesis and so on. For the nodules located in the deep layer of fat is not easy to be found, so the examination generally has no positive findings, but can exclude degeneration of the spinal canal, such as spinal stenosis, lumbar spondylolisthesis and lumbar disc herniation.
Relevant tests: Straight leg raising test and strengthening test for sensory function and sputum reflex disorder.
Diagnosis
Diagnosis and differentiation of iliac fascia fat sputum
Diagnostic points
(1) There are many young women, more women than men, and most of them are obesity signs.
(2) Deep subcutaneous tissue of the ankle touches painful nodules, nodules or single or multiple, round or elliptical nodules, smooth surface without adhesion, base is relatively fixed, slightly harder than lipoma, easier in prone position Touching, it is more obvious to roll up and down in the deep part, and the compression nodules cause radioactive soreness and pain in the ipsilateral lower limbs or buttocks.
(3) The straight leg raising test and the strengthening test were negative, there was no sensory disturbance in the distribution area of the sciatic nerve, the tendon reflex was normal, and there were no symptoms of other nerve roots.
(4) X-ray or CT scan, the nodules in the deep layer of fat are not easy to be found, so the examination generally has no positive findings, but can exclude degeneration of the spinal canal, such as spinal stenosis, lumbar spondylolisthesis and lumbar disc herniation.
Differential diagnosis
1. Lipoma: local adipose tissue degeneration, fibrositis and other lesions, because the posterior branch of the lumbar nerve is not pressed, the patient has no symptoms of waist and leg pain, the pressure of the mass does not have lower limbs or hips, radioactive soreness, but very few secondary sterility Sexual inflammation involving the posterior branch of the lumbar nerve can produce corresponding symptoms, which is difficult to identify. No pupil can be found during surgery.
2. Lumbar disc herniation, spinal stenosis, lumbar spondylolisthesis, etc.: According to the straight leg elevation test, there is no sensory function and sacral reflex disorder, CT, X-ray can be identified, and lumbosacral nodules can be found Sexual mass.
