Purpose: To assess for pain originating from the sacroiliac joint.
Test Position: Supine.
Performing the Test: The examiner is standing on the tested side. The examiner reaches around behind the patient and places a hand to stabilize the sacrum from the opposite side. The examiner uses his/her other hand to produce posteriorly directed forces through the femur at varying angles of abduction and adduction. The test is positive if pain in the buttock region is produced. Due to forces going through the hip joint as well, the patient may experience pain if pathology is located in the hip as well.
Diagnostic Accuracy: Sensitivity: .80, Specificity: 1.0; -LR: .2 ("Pain provocation tests for the assessment of sacroiliac joint dysfunction").
Importance of Test: When this test is clustered, it can prove highly useful in identifying those suffering from sacroiliac joint dysfunction. Check out the Lumbar Spine/Sacroiliac home page for the cluster. This tests the sacroiliac joint, because one hand is stabilizing the sacrum, while the other is creating forces through the femur that are transferred to the inominate. At varying angles, this test can assess for different locations of SI injury. Since the forces must pass through the hip prior to going to the SI joint, the hip is being stressed as well. Patients with femoral acetabular impingement, labral dysfunciton, or other hip pathologies may describe pain during this test.
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.