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What Causes Severe Pain In Right Buttock And Iliac Crest Post Injury?
Question: I fell about 3-4 months ago, slipped on my porch and my feet went out from under me (in front of me), causing me to land HARD onto a bucket rim on my right buttock and mid spine, bucket was full of water and had absolutely no give. After I hit, then the bucket tipped over and dumped on me. Now i have pain in my mid right buttock and the top of the right buttock, but when I rise from a sitting position my iliac crest hurts very bad, along with the buttock pains, but the iliac is the worst. X-Ray showed no findings. I am having MRI of my lower back and SI Joint, but Im unsure if this is actually the problem. I am a RN, have stenosis and bulging disc with one small herniation (prior to fall). The pain is in the upper buttock, mid buttock, but the most pain is the iliac crest on that same side (top of pelvis, anterior). Is there any other specific test I should/could mention to my doctor? She is kinda going on my requests on what tests to run. I havent worked in a while and was hoping to return at some point, but this has changed my plan. It hurts when I sit on that side too. Could I have possibly caused some kind of "ricochet" and possibly caused a hairline fracture to the pelvis (iliac)? Or just possibly referred pain. My MRI will be without contrast. Thanks Any advice please. Ive had multiple health problems and this is hindering me tremendously.
Brief Answer:
Get a CT scan with 3D reconstruction done
Detailed Answer:
Hello.
Welcome to HCM.
This is Dr. Swarnava Dattagupta answering your query.
I have gone through your detailed query and understand your concern.
This can be a soft tissue injury but the chances of bony injury cannot be ruled out. You are getting an MRI done which will reveal any soft tissue or muscular injury. You have said that an Xray has also been done but no bony abnormality has been found. In such case, a CT scan pelvis with both hip joint with 3D reconstruction can reveal any minute bony injury.
For the time being, you can take oral painkillers, apply painkiller gel locally, take trypsin-chymotrypsin tablets if there is any swelling, avoid excess weight bearing on the affected hip and limb, do simple exercises like isometric spinal exercises and straight leg rising etc.
You can send me the Xray and MRI plates and reports so that I can help you further regarding the diagnosis and management.
Also, getting clinically examined by an orthopedician would be helpful. Accordingly, treatment can be planned.
Hope this was helpful.
You can consult me for any further queries.
Regards.
Get a CT scan with 3D reconstruction done
Detailed Answer:
Hello.
Welcome to HCM.
This is Dr. Swarnava Dattagupta answering your query.
I have gone through your detailed query and understand your concern.
This can be a soft tissue injury but the chances of bony injury cannot be ruled out. You are getting an MRI done which will reveal any soft tissue or muscular injury. You have said that an Xray has also been done but no bony abnormality has been found. In such case, a CT scan pelvis with both hip joint with 3D reconstruction can reveal any minute bony injury.
For the time being, you can take oral painkillers, apply painkiller gel locally, take trypsin-chymotrypsin tablets if there is any swelling, avoid excess weight bearing on the affected hip and limb, do simple exercises like isometric spinal exercises and straight leg rising etc.
You can send me the Xray and MRI plates and reports so that I can help you further regarding the diagnosis and management.
Also, getting clinically examined by an orthopedician would be helpful. Accordingly, treatment can be planned.
Hope this was helpful.
You can consult me for any further queries.
Regards.
Above answer was peer-reviewed by :
Dr. Prasad
When I had 4 herniated discs in my neck, one so severe it had deviated my spinal cord and i lost reflexes and feeling in my right arm/hand, the xray showed nothing, even showed normal vertebrael height but the discs were totally desiccated. The MRI showed the damage. I do not trust xrays, of course they only reveal bony disturbances. So after the MRI, you think I should suggest to my doctor to get this CT with 3d reconstruction? Or will the MRI not show what this test would show? Possibly skip the MRI and schedule this test instead?
Brief Answer:
A CT scan should be done
Detailed Answer:
Hello there, Welcome back to HCM .
As the pain has persisted for quite some time, bony injury should be excluded first. So as Xray revealed nothing, CT scan is the next option to detect minute bony injuries, if any. So I would suggest it to be done.
Whereas, MRI can reveal soft tissue injury. So, it should also be done but only after thorough physical examination by your Orthopaedician . It can rule out any soft tissue damage from the trauma as well as give the present picture of your lumbar canal stenosis and disc herniation.
Therefore I would put emphasis on clinical examination by an orthopedician as it is very important in cases of long standing pain due to trauma.
Do continue with the conservative management as advised above.
It will help relieve pain and continue your daily activities.
Hope this helps.
Regards.
A CT scan should be done
Detailed Answer:
Hello there, Welcome back to HCM .
As the pain has persisted for quite some time, bony injury should be excluded first. So as Xray revealed nothing, CT scan is the next option to detect minute bony injuries, if any. So I would suggest it to be done.
Whereas, MRI can reveal soft tissue injury. So, it should also be done but only after thorough physical examination by your Orthopaedician . It can rule out any soft tissue damage from the trauma as well as give the present picture of your lumbar canal stenosis and disc herniation.
Therefore I would put emphasis on clinical examination by an orthopedician as it is very important in cases of long standing pain due to trauma.
Do continue with the conservative management as advised above.
It will help relieve pain and continue your daily activities.
Hope this helps.
Regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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