E2111. Pictorial Review of Pregnancy-Related Musculoskeletal (MSK) Injuries and Disorders
  1. Se-Young Yoon; Beth Israel Deaconess Medical Center
  2. Jessica Illuzzi; Yale New Haven Health Hospital/University School of Medicine
  3. Jim Wu; Beth Israel Deaconess Medical Center
Alterations in hormones, weight-bearing axis, load and other physiologic changes predispose pregnant patients to multiple musculoskeletal (MSK) disorders. Additionally, the strenuous course of labor and delivery can result in acute injuries. A radiologist’s exposure to this group of pathologies may be limited due to its specific patient population and brief time span.

Educational Goals / Teaching Points
A variety of MSKl conditions can occur or be exacerbated during pregnancy. The typical presentation, imaging features, and clinical management for pregnancy related MSK disorders will be discussed. The goal of this exhibit is to provide radiologists with an overview of the wide range of disorders to aid in diagnosis and clinical input.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Key pathophysiologic issues, typical presentations, imaging findings, and clinical management of pregnancy-related MSK disorders and injuries will be reviewed. Acute traumatic injuries related to childbirth include pubic symphyseal diastasis, hip labral tears, and sacral and coccygeal fractures. Nervous system injury such as lumbosacral plexopathy, which may be related to piriformis syndrome, as well as sciatica secondary to disc herniation can also result. Alterations in inflammatory processes during pregnancy can be demonstrated by new development of or change in preexisting rheumatoid arthritis. Additional processes during and after pregnancy include osteitis pubis and sacroiliitis, carpal tunnel syndrome, and De Quervain’s tenosynovitis. Infection, which can be secondary to delivery itself, may present as osteomyelitis, septic arthritis, and pelvic abscesses. Metabolic derangements may cause osteoporosis (e.g., transient osteoporosis of hip), which can be associated with stress fractures and osteonecrosis. Lastly, development or progression of neoplastic processes during pregnancy, such as desmoid tumors/fibromatosis and vascular malformations, will be discussed

Recognizing and understanding these disorders and injuries of pregnancy and childbirth help radiologists in guiding clinical management of the intrapartum and postpartum patients.