The spine of the ischium. Specific symptoms also develop. Ischium: Anatomy

Located at the base of the spine, the pelvic bones, coccyx and sacrum serve as a bone receptacle and support for vital important organs located in this area, and also provide attachment to the body lower extremities.

The structure of the ischium

In the structure of the ischium, there are:

The ischial spine (bone protrusion) is located on the back surface of the body of the bone.

The posterior obturator tubercle of the ischium is located on the anterior edge of the branch of the bone.

The sciatic tubercle in the form of a thickening with a rough surface is located on a curved section of the branch (posterior bottom surface).

The lower part of the branch of the ischium fuses with the pubic bone ( lower branch) .

The ischial and pubic bones limit the obturator foramen top edge which passes a wide obturator groove with the same name vessels and nerves.

Causes of pain in the ischium

Hip pain can be caused various reasons including both trauma and inflammatory diseases hip joint and infectious processes.

Fracture of the ischium most often occurs due to a fall on the buttocks or compression of the pelvis. The ischial bones hurt, as a rule, when moving, especially when bending the lower leg. Clarify the diagnosis with the help of x-rays.

Treatment of ischial fractures should begin with pain relief at the fracture site.. In most cases, with unilateral and some bilateral fractures of the ischium without displacement of bone fragments, it is enough to take an average physiological position with the limbs apart or use a special orthopedic bed. The entire treatment period usually takes no more than a month.

Full recovery after a fracture, as well as a full load on the leg, is possible no earlier than after seven weeks. For rehabilitation after a fracture of the ischium, physiotherapy, massage and physiotherapy exercises are used.

When the fragments are displaced, it is necessary to carry out treatment using the system skeletal traction for the condyles femur. In cases where treatment is not carried out on time, this can eventually lead to the development of osteoarthritis of the hip joint with pronounced violation support function limbs.

Sitting bones hurt too:

The ischium is one of the three bones that, together with the ilium and pubis, form the pelvic bone. After 16-17 years, these bones are connected with the help of cartilage, and later, after complete ossification of the cartilage, the boundaries between them are completely smoothed out.

Located at the base of the spine, the pelvic bones, coccyx and sacrum serve as a bone receptacle and support for the vital organs located in this area, and also provide attachment to the body of the lower extremities.

The structure of the ischium

In the structure of the ischium, there are:

• The body of the bone that forms the acetabulum (posterior inferior section);
• Branches of the ischium.

The ischial spine (bone protrusion) is located on the back surface of the body of the bone.

The posterior obturator tubercle of the ischium is located on the anterior edge of the branch of the bone.

The ischial tubercle in the form of a thickening with a rough surface is located on a curved section of the branch (posterior inferior surface).

The lower part of the branch of the ischium fuses with the pubic bone (lower branch).

The ischial and pubic bones limit the obturator foramen, along the upper edge of which there is a wide obturator groove with the same name vessels and nerves.

Causes of pain in the ischium

Pain in the pelvic bones can be caused by various causes, including both trauma and inflammatory diseases of the hip joint and infectious processes.

Fracture of the ischium most often occurs due to a fall on the buttocks or compression of the pelvis. The ischial bones hurt, as a rule, when moving, especially when bending the lower leg. Clarify the diagnosis with the help of x-rays.

Treatment of fractures of the ischium should begin with anesthesia of the fracture site. In most cases, with unilateral and some bilateral fractures of the ischium without displacement of bone fragments, it is enough to take an average physiological position with the limbs apart or use a special orthopedic bed. The entire treatment period usually takes no more than a month.

Full recovery after a fracture, as well as a full load on the leg, is possible no earlier than after seven weeks. For rehabilitation after a fracture of the ischium, physiotherapy, massage and physiotherapy exercises are used.

When the fragments are displaced, it is necessary to carry out treatment using a skeletal traction system for the condyles of the femur. In cases where treatment is not carried out on time, this can eventually lead to the development of osteoarthritis of the hip joint with a pronounced violation of the supporting function of the limb.

The sit bones also hurt:

• With intense sports. In this case, pain can be caused by both heavy loads and inflammatory processes, for example, inflammation of the ischial bursa (ischio-buttock bursitis), which often occurs when cycling. In inflammatory processes, as a rule, drug treatment and physiotherapy are carried out;
• With tumors of the pelvic bones. Depending on the rate of tumor growth, pain can be felt both on the bone and in the tissues surrounding it. This is most characteristic of fibrosarcoma or histiocytoma;
• In diseases of the blood system, namely in acute leukemia, diseases of the bone marrow, erythremia, chronic myeloid leukemia, multiple myeloma;
• Against the background of the development of such infectious diseases as tuberculosis and osteomyelitis of the pelvic bones;
• In metabolic diseases of the bones as a result of impaired resorption or formation of bone tissue due to a deficiency of minerals in the diet, a violation of their absorption in the intestine or due to a deficiency or disturbance in the metabolism of vitamin D.

The pelvic girdle has a paired pelvic bone (os coxae) (Fig. 92), which is formed by fusion of the ilium, pubis and ischium. AT pelvic bone there are educations that are absent in individual bones pelvis.

92. The pelvic bone is right.

1 - ala ossis ilii;
2 - crista iliaca;
3 - liea glutea anterior;
4 - spina iliaca anterior superior;
5 - spina iliaca anterior inferior;
6 - linea glutea anterior;
7 - acetabulum;
8 - os pubis;
9 - for. obturatum;
10 - os ischii;
11 - incisura ischiadica minor;
12 - spina ischiadica;
13 - incisura ischiadica major;
14 - spina iliaca posterior inferior;
15 - spina iliaca posterior superior;
16 - linea glutea posterior.

The acetabulum (acetabulum) is located in the center of the pelvic bone on outer surface. Formed by the bodies of the ilium, pubic and ischium bones. The acetabulum serves to connect to the head of the femur. In the lower part, the high edge of the acetabulum is interrupted by a notch (incisura acetabuli). The articular surface does not cover the entire acetabulum, but only 2/3 of it and is called the lunate surface (facies lunata). The remaining 1/3 of the fossa - the bottom - is rough and does not come into contact with the head of the femur.

The obturator opening (for. obturatum) is located in front of and below the acetabulum and is limited by the branches of the pubic and ischial bones. Has an oval shape; in women it is somewhat larger and the length is oriented forward.

Ilium

The ilium (os ileum) is flat, has an oval ridge at the top, and the body involved in the formation of the acetabulum below. Ahead, the crest ends with the anterior superior spine (spina iliaca anterior superior), below which there is a lower spine (spina iliaca anterior inferior). Behind the crest also ends with two awns. On the medial side of the posterior spines there is tuberosity (tuberositas iliaca) and the articular surface, which has the shape auricle(facies auricularis). The part of the bone between the crest and the body is called the wing (ala ossis ilii); the iliac fossa (fossa iliaca) is visible from its inner side, and lines (linea glutea anterior, posterior et inferior) are located outside the wing - a trace of attachment of three gluteal muscles. Below, the iliac fossa of the wing is delimited from part ilium, involved in the formation of the small pelvis, an arcuate line (linea arcuata). This line is complemented in front by the crest of the pubic bone (pecten ossis pubis).

Pubic bone

The pubic bone (os pubis) is paired, has lower and upper branches (rr. inferior et superior). The lower branch connects to ischium, and the upper branch passes into the body, which is involved in the formation of the acetabulum. At the junction of the upper and lower branches, an angle is formed, which limits the obturator opening in front. On the lower surface of the upper branch there is a groove (sulcus obturatorius), along which the corresponding nerve and vessels pass to the thigh. On the medial side, the angle has a platform - the junction with another pubic bone (symphysis). To the side of the site on the upper surface is the pubic tubercle (tuberculum pubicum), from which a ridge runs back and to the side, complementing the arcuate line of the pelvis. It was noted that the farther from the site of the angle of the pubic bone the pubic tubercle is located, the wider the external opening of the inguinal canal, which predisposes to inguinal hernias.

Ischium

The ischial bone (os ischii) is paired, as well as the pubic one, has a branch (ramus) and a body (corpus). The branch connects to the inferior branch of the pubis, and the body forms the posteroinferior fragment of the acetabulum. At the junction of the branches, an angle is formed that closes the obturator foramen. In the region of the angle there is a thickening of the bone substance, called the ischial tuberosity (tuber ischiadicum). Above this tubercle is a small sciatic notch (incisura ischiadica minor), which is separated by an awn (spina ischiadica) from a large sciatic notch (incisura ischiadica major).

Ossification. All pelvic bones go through three stages of development. First at 9 weeks prenatal development the nucleus of ossification appears in the ilium, for the fourth month - in the body of the ischium, for the fifth month - in the body of the pubic bone. In a newborn, the pelvic bones are mostly cartilaginous. In the 8th year, the lower branches of the ischial and pubic bones fuse, at the age of 14-16 the bodies of all bones fuse and form the bone acetabulum. At the age of 8-12, additional ossification points appear on the iliac crest, iliac and ischial spines, and ischial tuberosity, which fuse with the pelvic bones by the age of 20-25.

X-rays of the pelvic bones

Pictures of the pelvic bones are produced in the posterior, frontal and lateral projections. The picture should show the bones of the pelvis, sacrum, lower lumbar vertebrae and hip joints(Fig. 93). In the middle, a gap of the symphysis (7-8 mm) is visible, on the right and left - the iliac-sacral joint. The pelvic bones, the triangular-shaped sacrum, the obturator foramen, the entrance to the pelvis and the hip joint gap are clearly visible.

93. X-ray of the pelvic bones of an adult.
1 - iliac crest; 2 - anterior superior iliac spine; 3 - anterior lower spine; 4 - border line; 5 - the upper branch of the pubic bone; 6 - lower branch of the pubic bone; 7 - obturator opening; 8 - pubic tubercle; 9 - branch of the ischium; 10 - ischial tubercle; 11 - branch of the ischium; 12 - head of the femur.

More than 200 small and large bones work in the human body every day. The ischium is located in the pelvis and is one of the largest and densest in the body. She performs important features and is subjected to considerable stress every day, as in sedentary manner human life, and during intensive sports.

Anatomy of the ischium

The ischium is made up of large body and curved branches. Its anatomy is characterized by the following:

• in front, the branch of the bone is connected to the pubic joint;
• rear and bottom limits the obturator opening;
• below is a tubercle;
• the axis of the ischium is located between the large and small notch;
• the type of connection of the ilium and ischium of the pelvis is fixed.

Together with other bones, the ischium forms the pelvis, and is also the largest in this belt. The ischial structure is located at the base of the spine and is closely related to the coccyx, the sacrum.

In newborns, the pelvic bones are highly mobile, so the pictures often show the presence of three separate elements of the belt: the ischium, the pubic bone, iliac joint. With age, the type of connection between the pubic and ischium changes, they literally grow together and become much denser.

The zone of attachment of the limbs to the pelvis is called the acetabulum - it is a hemispherical formation, ideally smooth inside. Attached to the head hip bone, as well as the largest joint in the body.

Differences in bone anatomy in different sexes

Due to the fact that the ischial bones in the female pelvis are adapted for labor and form the birth canal, their structure and functional features significantly different from the capabilities of the element in male body. Until some time, in boys and girls, this difference in structure is practically absent. Bones begin to change during puberty - the sex hormones estrogens act on this.

It is because of estrogens that some young men have a too wide pelvis, developed along female type, which may indicate the presence hormonal disorders and endocrine diseases in the body.

If a girl has an insufficient level of estrogen and the functions of the ovaries change, the pelvis narrows. In the future, this prevents natural childbirth and requires caesarean section. Also, hormonal imbalance can lead to osteoporosis in adulthood, this disease in 80% of cases causes injuries and fractures of the hip bones.

Features of location in men and women

In men, the ilium and ischia are already located and form a funnel downwards, while female pelvis more like a forward curved cylinder. The distance between the awns in the male pelvis is much less than in the female. Also, in women, the tubercles are at a considerable distance from each other and are divorced to the sides. In women, the distance between the awns is 25-27 cm, while in men it is in the range of 22-23 cm.

Due to this difference in structure, it is possible to labor activity. The parameters of the pelvic bones in women are used in without fail to establish possible contraindications to natural childbirth.

In women, the pelvic bones are less durable and more smooth. Also, men and women have a different angle of contact of the pubic joint with the ischium: in men it is sharp, in girls it is straight. The timing of the formation and ossification of the pelvic girdle depends on gender. For guys, this period is delayed for 2-3 years. In the fair sex, the final stage of ossification falls on 20-25 years, while in guys it ends by 22 years.

Features of the ossification process

The process of ossification of the ischial structure is interesting in human anatomy:

• the first points are laid at the 4th month of fetal formation;
• if you take an x-ray before childbirth, the pictures will be clearly visible upper branches ischial joint;
• at the time of birth, all pelvic elements are connected to each other by cartilage, and not by bone structures;
• after 4-5 months of life, the lower branches begin to form in the child;
• the process of branch formation is completed by 2 years of age.

This process is characterized by an asymmetric course, therefore, on an x-ray, the baby's bones on one side can differ significantly from the image of the opposite zone.

The fusion of bones begins at the age of 7-8 years. During this period, the lower points are connected and the upper ones begin to form. If you look at the x-ray photo of the ischium, you can see the rounding of the upper part.

By the age of 13-17, the pubic and ischial zones are completely connected, the acetabulum is formed. By the age of 22-25, depending on the gender of the person, complete ossification occurs, fusion and smoothing of the seams.

Relationship of anatomy to injuries

During childhood and adolescence, coaches, parents, and other adults involved must take into account the particularities of the pelvic structures. This is especially true for girls - if they wear high heels or are engaged in intense sports (jumping, hitting the hips and pelvis), there is a high risk of deformation and displacement of the bones. All these factors lead to a narrowing of the pelvis - a serious complication that interferes with normal childbirth.

However, not only sports loads and heels can lead to deformation of the ischial sector. It is also affected by:

• prolonged stay in an uncomfortable standing position;
• constant carrying of weights;
• improper and prolonged sitting.

Violations are possible not only in girls, but also in guys. It is important that boys pay attention to the process of carrying weights: you can’t carry objects with one hand, stoop in sitting position put your feet under your buttocks.

Functions of the ischial joint

In addition to the fact that the correct position of the ischial bones is very important for women, their normal development provides the implementation of additional functions:

• protection of organs located in abdominal cavity, including: Bladder, intestines, elements of the reproductive system;
• supporting role - the ischium is included in the system of attachment of the lower extremities to the body.

Any unpleasant symptoms that bother for a long time should alert the person. Fractures, bruises, cracks and dislocations, as well as some others pathological processes extremely dangerous for the health of both the adult patient and the child.

The relationship of diseases with a violation of the position of the bone

The sciatic plexus contains many nerve endings, vessels, part of the spine and very tightly placed internal organs. Constant pain and discomfort in this area indicate injury, inflammation and infection:

• injuries are dangerous because the sciatic joint is displaced under the influence of a fracture or dislocation, its functions are impaired;
• sometimes cause acute pain become intense physical exercise- a person needs to reduce the amount of exercise, otherwise excessive stress lead to additional injury and inflammation (bursitis);
• neoplasms - shooting pains can occur due to tumors that form in cartilage or internal organs;
• blood diseases such as leukemia and bone marrow pathologies can cause constant discomfort throughout the body;
• tuberculosis and osteomyelitis of bones - infectious infections, at which appears heat and other symptoms;
• due to a lack of calcium, potassium, magnesium, vitamin D are violated metabolic processes, which in the early stages causes pain, and then pathology of the bones.

Needed for diagnosis instrumental methods research, "by eye" to make a diagnosis is impossible. Regular use of NSAIDs or other drugs in an attempt to relieve pain can harm the body.

AT human body there are more than 200 bones with a variety of structures. Each of them performs a specific role and provides normal work the whole organism. The pelvis contains the ischium, which is responsible for protecting and supporting the organs located in the lower part of the abdominal cavity. It is also designed to firmly attach the legs to the body. If you experience pain or injury to the ischium, you should immediately contact the emergency room, since some injuries are life-threatening.

The ischium consists of a body and a branch bent at an angle.

Anatomical structure:

• From below and behind it is a limiter of the obturator opening.
• The body of corpus ossis ischii is placed posterior to the obturator foramen.
• The branch merges anteriorly with the inferior branch of the pubis.
• A tubercle is located at the lower edge of the lesser sciatic notch.
• The axis is located between the lesser and greater ischial notch.

Ossification

If you take a picture on an X-ray machine infant, then you can consider the gaps in the pelvic bones. Between them is cartilage, which remains invisible on the x-ray. In the region of the acetabulum, there is no gap between the pubic and ischium bones, since they overlap and look like a single whole. In its form, the bone connection is similar to a claw. The hole in the pelvic bone (foramen obturatum) is not closed.

When a person reaches the age of eight, the branches of the ischium and pubis become one. And by the age of 16, the acetabulum connects with ilium and the pelvis is formed. In almost all areas of attachment of ligaments and muscles, additional ossification points appear ( this process goes up to 19 years). A complete fusion occurs by the age of 25.

Please note that it is by the second ten years of life that a specialist can find out the sex of a person from the pelvic bone. Additional bone formations are involved in synostosis in the region of the acetabulum. If they are stored in long time, then they are assigned to ossa acetabuli. On x-ray, they can be confused with fragments.

Pain

Cause pain can become an injury, inflammatory or infectious disease.

Pain occurs:

• With intense training and hard physical work.
• If a person is actively engaged in cycling, then there is a risk of developing inflammation of the ischial bursa (bursitis).
• Oncological neoplasms. Pain may radiate to surrounding tissues. It is observed during fibrosarcoma or histiocytoma.
• With a fracture, crack or puncture. Occurs when squeezing the pelvis or an unsuccessful fall on the buttocks.
• As a result of acute or chronic diseases from the circulatory system.
• During infection with specific microorganisms, osteomyelitis or tuberculosis is diagnosed.
• For metabolic diseases skeletal system. As a result of lack useful substances in the human diet, there are violations of resorption or tissue formation.

The disease can be diagnosed with an x-ray.

fracture

Violation of the integrity of the ischium is classified as dangerous and severe injuries support system. Since there is always a risk of complications with damage.

General symptoms:

• Swelling of the injured area.
• The patient lying on his back is unable to raise his straight leg. This state Also known as sticky heel syndrome.
• The pain becomes more intense when you try to turn to the side.

Additional signs of damage to the pelvic bone:

• Severe pain when moving the lower limbs.
• Paleness of the skin.
• Hypotension.
• Arrhythmia.
• Loss of consciousness.
• Problems with urination.
• In the case of a piercing fragment of the rectum or urethra, bleeding may begin from the anus or urethra.

Required urgent hospitalization sick. Only a traumatologist can prescribe effective treatment.

Structure (video)