The crest of the ilium (or iliac crest) is the superior border of the wing of ilium and the superolateral margin of the greater pelvis. Anatomy The iliac crest stretches posteriorly from
the anterior superior iliac spine (ASIS) to the posterior superior iliac spine (PSIS). Behind the ASIS, it divides into an outer
and inner lip separated by the
intermediate zone. The outer lip bulges laterally into the iliac tubercle. [1]Palpable in its entire length, the crest is convex
superiorly but is sinuously curved, being
concave inward in front, concave outward behind. [2] It is thinner at the center than at the
extremities. Muscles To the external lip are attached the Tensor fasciae latae, Obliquus externus abdominis, and Latissimus dorsi, and along its whole length the fascia lata; to the intermediate line the Obliquus internus abdominis. To the internal lip, the iliac fascia, the Transversus abdominis, Quadratus lumborum, Sacrospinalis, and Iliacus. Abdominal external oblique muscle Abdominal internal oblique muscle Transversus abdominis muscle Quadratus lumborum muscle Erector spinae Iliocostalis pars lumborum Longissimus pars thoracis[3] Latissimus dorsi Tensor fasciae latae Iliacus muscle Fascia lata Iliac fascia Transverse fascia Embryology The iliac crest is derived from endochondral bone. Clinical significance The iliac crest has a large amount of red bone marrow, and thus it is the site of bone marrow harvests (from both sides) to
collect the stem cells used in bone marrow transplantation. The iliac crest is also considered the most ideal donor site for
bone grafting when a large quantity of
bone is needed. For example, oral surgeons
will often use iliac crest bone to fill in large
osseous defects of the oral cavity caused
from severe periodontal disease, excess bone resorption following tooth loss, or trauma [4] The top of the iliac crests also marks the level of the fourth lumbar
vertebral body (L4), above or below which lumbar puncture may be performed.
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