Sacral Clearing Test (Sacral Thrust)
Purpose: To decide if sacroiliac joint is the source of the patient's symptoms or not.
Test Position: Prone.
Performing the Test: Examiner applies a posteroanteriorly directed force to various locations of the sacrum: base, apex, and each side of the sacrum medial to the PSIS (sacral sulcus). Next, the examiner applies a cephalad pressure on the sacrum at each position: base and apex (to apply cephalad pressure, first compress the tissues, then apply cephalad force). If a sulcus is deeper than the other, a pressure is applied to the opposite inferior angle to test for torsional abnormalities to the sacroiliac joint.
Diagnostic Accuracy: Sensitivity: .63; Specificity: .75 ("Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests").
Importance of Test: This test assesses for sacroiliac pain by applying pressures at various locations of the sacrum. By placing pressure in those various areas, forces are applied to the SI joint at different angles to test for lesions. While this test is called the sacral clearing test, one should be careful of using it as a true clearing test, due to the low diagnostic accuracy. However, when this test is clustered with others, the diagnostic accuracy greatly improves.
Note: tests should only be performed by a properly trained health care practitioner.
Test Position: Prone.
Performing the Test: Examiner applies a posteroanteriorly directed force to various locations of the sacrum: base, apex, and each side of the sacrum medial to the PSIS (sacral sulcus). Next, the examiner applies a cephalad pressure on the sacrum at each position: base and apex (to apply cephalad pressure, first compress the tissues, then apply cephalad force). If a sulcus is deeper than the other, a pressure is applied to the opposite inferior angle to test for torsional abnormalities to the sacroiliac joint.
Diagnostic Accuracy: Sensitivity: .63; Specificity: .75 ("Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests").
Importance of Test: This test assesses for sacroiliac pain by applying pressures at various locations of the sacrum. By placing pressure in those various areas, forces are applied to the SI joint at different angles to test for lesions. While this test is called the sacral clearing test, one should be careful of using it as a true clearing test, due to the low diagnostic accuracy. However, when this test is clustered with others, the diagnostic accuracy greatly improves.
Note: tests should only be performed by a properly trained health care practitioner.
Pressure applied at base of sacrum
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Pressure applied at apex of sacrum
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Pressure applied at sacral sulcus (medial to PSIS)
References:
Laslett M, Aprill CN, McDonald B, Young SB. "Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests." Man Ther. 2005 Aug;10(3):207-18. Web. 08/22/12.
Laslett M, Aprill CN, McDonald B, Young SB. "Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests." Man Ther. 2005 Aug;10(3):207-18. Web. 08/22/12.
