Skills Lab: Abdominopelvic Pain: Clinical Evaluation with Complementary Ultrasonography and Intervention

Saturday, October 22, 2022

2:00 PM – 5:00 PM ET

Location: Hilton Key 10

Skills Lab Director(s)

Reina Nakamura, DO

University of Michigan
Ann Arbor, Michigan

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

PDF of Slides

Skills Lab Faculty(s)

Se Won Lee, MD

Program director
HCA Healthcare Sunrise Health Graduate Medical Education PM&R Program
Las Vegas, Nevada

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Mohammed Emam, MD

Assistant Professor
Johns Hopkins University
Towson, Maryland

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Mahmood Gharib, MD

Assistant Professor, Medical Spine Medical Director
University of Minnesota
Minneapolis, Minnesota

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
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Adam Lewno, DO

University of Michigan
Ann Arbor, Michigan

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
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Julia M. Webb, MD

Clinical Assistant Professor
University of Michigan
Ann Arbor, Michigan

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
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Ashley Niemi, PT, DPT, CLT

Plymouth Physical Therapy Specialists
Plymouth, Michigan

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Pelvic pain is under-recognized among physiatrists due to overlap with low back pain and abdominal pain despite high prevalence. The overlap between chronic pelvic pain and abdominal wall pain is approximately 30%. An understanding of biomechanics and different pain-generating anatomical structures in the abdomen and pelvis are essential for appropriate management.

The differential diagnoses for abdominopelvic pain are wide, including pathology of bone and joints (pubic symphysis, sacroiliac joint and hip joint), muscles and tendons (piriformis, gluteus medius, obturator internus, quadratus femoris, abdominal wall muscles, and pelvic floor muscles), ligaments (Sacroiliac and iliolumbar ligaments) and nerves (pudendal, lateral femoral cutaneous, and cluneal nerves). One must also include referred pain from visceral structures (bladder, uterus, and GI tract) as well as spine pathology (lumbosacral radiculopathy, facet arthropathy, disc disease, and coccyx) in the differential diagnosis. Most importantly, while investigating nociceptive noxious stimuli the astute clinician must also consider if central sensitization contributes to the clinical scenario.

Learning Objectives:

Recognize different pathologies from different anatomic structures typically associated with abdominopelvic pain based on history and clinical examination.
Identify surface anatomical landmarks and palpate the location of common pathologies contributing to abdominopelvic pain.
To be able to scan different anatomic structures related to abdominopelvic pain.
Recognize the typical abnormal ultrasonographic findings of commonly involved structures in abdominopelvic pain.