The tests for pelvic girdle pain (PGP) involve a combination of pain provocation, pain palpation, and functional assessments.
Types of Tests for Pelvic Girdle Pain
PGP diagnosis relies on several tests to assess pain and functionality in the pelvic region. These tests are crucial for identifying the source of discomfort and determining the appropriate treatment strategy. The tests can be categorized as:
- Pain Provocation Tests: These tests aim to reproduce the pain experienced by the individual, helping to confirm PGP.
- Pain Palpation Tests: These involve physically examining specific ligaments and the symphysis for tenderness, which can indicate PGP.
- Functional Tests: These assess how the pelvic girdle functions, often revealing movement limitations or pain when performing specific activities.
Detailed Examination Methods
| Test Category | Specific Test | Description |
|---|---|---|
| Pain Provocation | P4/thigh thrust | The examiner applies a posterior force to the flexed hip joint, attempting to provoke pain in the pelvic region. |
| Patrick's Faber | The patient flexes, abducts, and externally rotates their hip; pain may indicate sacroiliac joint issues. | |
| Gaenslen's test | The patient lies supine with one leg flexed towards the chest and the other extended off the edge of the table; pain provocation is noted. | |
| Modified Trendelenburg's test | Assesses hip abductor strength; excessive pelvic drop on the unsupported side may suggest weakness related to PGP. | |
| Pain Palpation | Long dorsal ligament test | Examiner palpates the long dorsal ligament for tenderness. |
| Palpation of the symphysis | The symphysis pubis is palpated for tenderness, which can indicate PGP. | |
| Functional Test | Active straight leg raise (ASLR) test | The patient attempts to raise one leg while lying on their back. This functional test identifies limitations or pain when performing this activity. |
How the Tests are Used
- Pain Provocation Tests: These tests are performed by a healthcare provider to provoke the pain felt by the individual. Positive test results indicate PGP may be present. Examples include:
- P4/thigh thrust: Involves applying pressure to the flexed hip to replicate pain.
- Patrick's Faber: Moving the leg into a figure-four position may provoke pain.
- Gaenslen's Test: Moving one leg towards the chest while the other hangs off the edge of the table is a test to evaluate PGP.
- Modified Trendelenburg's Test: Observing the hip drop when standing on one leg identifies muscle weakness.
- Pain Palpation Tests: These tests involve physically feeling areas associated with PGP. Examples include:
- Long dorsal ligament test: Palpating the long dorsal ligament for tenderness.
- Palpation of the symphysis: Pressing the symphysis pubis to find areas of tenderness.
- Functional Test
- Active Straight Leg Raise (ASLR) Test: This test assesses the functional impact of PGP by observing the patient's ability to lift a leg while supine, often revealing limitations or pain associated with PGP.
By using these different tests, healthcare providers can effectively assess and diagnose PGP. A comprehensive evaluation includes a combination of these methods, ensuring a thorough and accurate assessment.
