The tests for Sacroiliac Joint (SIJ) dysfunction primarily involve physical examination maneuvers designed to provoke pain in the joint.
Physical Exam Provocative Tests for SIJ Dysfunction
Specific physical exam provocative tests for SIJ dysfunction, as identified in our reference, include:
- FABER test: Also known as the Patrick test, this involves flexing, abducting, and externally rotating the hip.
- Compression test: Applying direct compression over the sacroiliac joints.
- Distraction test: Applying a force to distract the sacroiliac joints.
- Thigh thrust test: Applying a posterior force to the femur when the hip is flexed.
- Gaenslen test: Applying pressure to each leg with the patient in a side-lying position.
A diagnosis of SIJ pain is typically made when at least three out of these five provocative maneuvers result in a positive pain response.
How the Tests Work
These tests work by applying stress or movement to the SI joint, attempting to reproduce the patient's pain. If the joint is inflamed or dysfunctional, these tests are likely to elicit a positive pain response.
Examples of Provocative Tests
- FABER Test (Flexion, ABduction, External Rotation):
- The patient lies on their back.
- The examiner places the patient's leg into a figure four position with the ankle on the opposite knee.
- The examiner gently lowers the bent knee towards the table.
- Pain in the SI joint or hip indicates a positive test.
- Thigh Thrust Test:
- The patient lies on their back.
- The examiner flexes the hip and knee to 90 degrees.
- The examiner then applies a posterior thrust through the femur.
- Pain in the SI joint indicates a positive test.
Important Considerations
- These tests are best used in combination.
- A positive test does not confirm SIJ dysfunction without clinical correlation.
- Imaging studies like X-rays or MRIs may be used to rule out other causes.
- The use of at least three positive provocation tests has been suggested in the reference.
In conclusion, the physical examination tests for SIJ include the FABER, compression, distraction, thigh thrust, and Gaenslen tests, and at least three positive responses are commonly used for a potential diagnosis of SIJ dysfunction.
