Dr. Eck received a Bachelor of Science degree from the Catholic University of America in Biomedical Engineering, followed by a Master of Science degree in Biomedical Engineering from Marquette University. Following this he worked as a research engineer conducting spine biomechanics research. He then attended medical school at University of Health Sciences. He is board eligible in orthopaedic surgery.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The most common symptom of SI joint dysfunction is pain. Patients often
experience pain in the lower back or the back of the hips. Pain may also be
present in the groin and thighs. In many cases, it can be difficult to determine
the exact source of the pain. Your physician can perform specific tests to help
isolate the source of the pain. The pain is typically worse with standing and
walking and improved when lying down. Inflammation and arthritis in the SI joint
can also cause stiffness and a burning sensation in the pelvis.
How is sacroiliac joint dysfunction diagnosed?
The first step in diagnosis is typically a thorough history and physical
examination by a physician. The physician will ask questions to determine if
there are any underlying disorders that could be causing the patient's pain. This can
also help differentiate pain coming from the SI joints, lumbar spine, or hips.
There are various tests a physician can perform during the physical
examination that can help isolated the source of the pain. By placing your hips and legs in certain positions and applying pressure, the SI joints can be moved or compressed to identify them as a source of pain. Other portions of
the examination are to exclude certain possibilities that could mimic sacroiliac
disease.
The next step in diagnosis is often plain radiographs (X-rays). The patient may have
X-rays of the pelvis, hips, or lumbar spine depending on what the physician
finds on the history and physical examination. A
computed tomography (CAT or
CT) scan may also help in the diagnosis. A CT scan gives a more detailed look at the
joint and bones. Both X-rays and CT scans can help identify sacroiliitis. This can appear as sclerosis in the joints. More severe wear in the joints can appear as erosion of the bone around the SI joints. These tests can also look for fusion of the SI joints. A magnetic resonance imaging (MRI) scan can also be helpful.
This provides a better evaluation of the soft tissues, including muscles and
ligaments. It can also identify subtle fractures that may not be seen on an
X-ray. The MRI can identify inflammation in the SI joint by the presence of
excessive fluid in the joint. A bone scan can be obtained to help isolate the
source of your pain and can be used to identify bony abnormalities. The bone
scan can identify areas of increased activity in the bone. This is a nonspecific
test and can be positive in cases of arthritis, infection, fracture, or tumors of bone.
Often the most accurate method of diagnosing SI joint dysfunction is by
performing an injection that can numb the irritated area, thereby identifying
the pain source. An anesthetic material (for example,
lidocaine [Xylocaine]) can be
injected along with a steroid (cortisone) directly into the SI joint. This is
usually performed with the aid of an X-ray machine to verify the injection is in
the SI joint. The anesthetic and steroid can help relieve the pain from
inflammation that is common with SI joint dysfunction. The duration of pain
relief is variable, but this is very useful to determine that the SI joint is
the source of the pain.
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Gout is a condition that results from crystals of uric acid depositing in tissues of the body. Gout is a condition that can lead to abnormally elevated levels of uric acid in the
blood, recurring attacks of joint inflammation (arthritis), deposits of
hard lumps of uric acid in and around the joints, and decreased kidney
function and kidney stones.
There are many symptoms involved in the 1st, 2nd and 3rd trimesters of pregnancy. The first early pregnancy symptom is typically a missed period, but others include breast swelling and tenderness, nausea and sometimes vomiting, fatigue and bloating. Second trimester symptoms include backache, weight gain, itching, and possible stretch marks. Third trimester symptoms are additional weight gain, heartburn, hemorrhoids, swelling of the ankles, fingers, and face, breast tenderness, and trouble sleeping. Read more to learn about recommended procedures and tests for each stage of a healthy pregnancy.
Psoriasis is a long-term skin condition that may cause large plaques of red, raised skin, flakes of dry skin, and skin scales. There are several types of psoriasis, including psoriasis vulgaris, guttate psoriasis, inverse psoriasis, and pustular psoriasis. Symptoms vary depending on the type of psoriasis the patient has. Treatment of psoriasis may include creams, lotions, oral medications, injections and infusions of biologics, and light therapy. There is no cure for psoriasis.
Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of
cartilage in the joints. Also known as degenerative arthritis. Osteoarthritis
can be caused by aging, heredity, and injury from trauma or disease.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited.
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick, spiral, comminuted, transverse, compound, or vertebral compression. Common fractures include: stress fracture, compression fracture, rib fracture, and skull fracture. Treatment depends upon the type of fracture.
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain includes: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Pregnancy planning is important to help prevent exposure of the mother and fetus to potentially harmful medications and substances during the early days, and throughout the pregnancy. Nutritional planning, prevention of birth defects, conditions such as high blood pressure, heart disease, diabetes, and kidney disease need careful monitoring. Gestational diabetes, preeclampsia, and pregnancy induced hypertension are conditions that may arise during pregnancy. Immunizations, inherited disorders, exercise, air travel, intercourse, and birth control are important factors to consider when planning a pregnancy.
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