Purpose: To assess for pain originating from the sacroiliac joint.
Test Position: Supine.
Performing the Test: The non-tested leg is kept in extension, while the tested leg is placed in maximal flexion. The examiner then places one hand on the anterior thigh of the non-tested leg and the other hand on the knee of the tested leg to apply a flexion overpressure (alternate position is on posterior thigh, proximal to knee, for patients that have knee pathology). The extended leg may also be placed off the table to create a greater force. A positive test occurs if it produces low back pain.
Diagnostic Accuracy: Sensitivity: .71; Specificity: .26; -LR: 1.12; +LR: 1.0 ("Pain provocation tests for the assessment of sacroiliac joint dysfunction").
Importance of Test:The test functions by stressing the tissues on the posterior side of the pelvis and creating motion at the sacroiliac joint. Due to the low diagnostic accuracy of this test, it is not useful in triangulating pain originating from the sacroiliac joint. This test pay appear positive on patients with hip pathology as well. The extreme flexed hip position is often painful/uncomfortable for patients with femoral acetabular impingment or labral dysfunction.
Note: tests should only be performed by a properly trained health care practitioner.
References: Broadhurst N, Bond M. "Pain provocation tests for the assessment of sacroiliac joint dysfunction." J Spinal Disorders 1998; 11: 341-345.