Painful pubic joint instability is the main indication of selective steroid injection of the pubic symphysis. It occurs mainly in multiparae (Fig. 16). It is however wise to first rule out pubic
joint infection. Pubic joint infection may complicate intrapelvic surgery or interventional procedure, as well as delivery or abortion. A spontaneously abortive pubic joint infection might be the first step of chronic pubic joint instability, because both diseases share the same radiological changes with subchondral bone erosion and joint space widening. In some cases, however, changes due to infection may be rapidly progressive on plain films or CT examinations. A soft tissue mass at CT or MR examinations would also help recognize infection. Finally, it is sometimes necessary to obtain bacteriological and pathological studies of pubic joint lavage or pubic subchondral bone samples prior to injecting steroid into pubic symphysis.
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Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.