Original Contribution  |   November 2015
Feasibility of Using Ultrasonography to Establish Relationships Among Sacral Base Position, Sacral Sulcus Depth, Body Mass Index, and Sex
Author Notes
  • From the Department of Osteopathic Manipulative Medicine (Dr Lockwood); the Department of Family Medicine, Preventive Medicine, and Community Health (Dr Kondrashova); and the A.T. Still Research Institute (Ms Johnson) at the A.T. Still University–Kirksville College of Osteopathic Medicine in Missouri. Dr Lockwood is currently affiliated with the Department of Osteopathic Manipulative Medicine at the Liberty University College of Osteopathic Medicine in Lynchburg, Virginia. 
  •  *Address correspondence to Tatyana Kondrashova, MD, PhD, 800 W Jefferson St, Kirksville, MO, 63501-1443. E-mail: tkondrashova@atsu.edu
     
Article Information
Imaging / Neuromusculoskeletal Disorders / Psychiatry
Original Contribution   |   November 2015
Feasibility of Using Ultrasonography to Establish Relationships Among Sacral Base Position, Sacral Sulcus Depth, Body Mass Index, and Sex
The Journal of the American Osteopathic Association, November 2015, Vol. 115, 648-653. doi:10.7556/jaoa.2015.135
The Journal of the American Osteopathic Association, November 2015, Vol. 115, 648-653. doi:10.7556/jaoa.2015.135
Abstract

Context: Identifying relationships among anatomical structures is key in diagnosing somatic dysfunction. Ultrasonography can be used to visualize anatomical structures, identify sacroiliac landmarks, and validate anatomical findings and measurements in relation to somatic dysfunction. As part of the osteopathic manipulative medicine course at A.T. Still University–Kirksville College of Osteopathic Medicine, first-year students are trained to use ultrasonography to establish relationships among musculoskeletal structures.

Objectives: To determine the ability of first-year osteopathic medical students to establish sacral base position (SBP) and sacral sulcus depth (SSD) using ultrasonography and to identify the relationship of SBP and SSD to body mass index (BMI) and sex.

Methods: Students used ultrasonography to obtain the distance between the skin and the sacral base (the SBP) and the distance between the skin and the tip of the posterior superior iliac spine bilaterally. Next, students calculated the SSD (the distance between the tip of the posterior superior iliac spine and the SBP). Data were analyzed with respect to side of the body, BMI, sex, and age. The BMI data were subdivided into normal (18-25 mg/kg) and overweight (25-30 mg/kg) groups.

Results: Ultrasound images of 211 students were included in the study. The SBP was not significantly different between the left and right sides (36.5 mm vs 36.5 mm; P=.95) but was significantly different between normal and overweight BMI categories (33.0 mm vs 40.0 mm; P<.001) and between men and women (34.1 mm vs 39.0 mm; P<.001). The SSD was not significantly different between left and right sides (18.9 mm vs 19.8 mm; P=.08), normal and overweight BMI categories (18.9 mm vs 19.7 mm, P=.21), or men and women (19.7 mm vs 19.0 mm; P=.24). No significant relationship was identified between age and SBP (P=.46) or SSD (P=.39); however, the age range was narrow (21-33 years).

Conclusion: The study yielded repeatable and reproducible results when establishing SBP and SSD using ultrasonography. The statistically significant relationship between SBP and higher BMI and between SBP and female sex may point to more soft tissue overlaying the sacrum in these groups. Further research is needed on the use of ultrasonography to establish criteria for somatic dysfunction.

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