Clinical examination of the sacroiliac joint

Abstract

Introduction: Sacroiliac joint (SIJ) can be a nociceptive source of the pain in lower back. Clinical diagnosis of SIJ pain remains yet problematic. The cause of SIJ pain is multifactorial. The pain may be a result of an inflammatory disease, arthrosis, traumatic injury, infectious process or overload. The potential role in SIJ examination have pain provocation tests. Objective: To review and further discuss the validity of some of the mostly used clinical provocation tests such as Distraction test, Thigh Thrust test, Compression test, Sacral Thrust test, Patrick’s (FABER), Gaenslen’s test, Standing Flexion Test, Gillet Test and Shimpi Prone test. Method: A literature search was conducted using PubMed. Reviewed were studies between 2005 and 2020 in English, Slovak and Czech with keywords: sacroiliac joint, sacroiliac assessment, provocation tests. The methodology of studies was not considered. Discussion: It is challenging to determine whether SIJ is the actual source of the pain by using only one of the provocation tests. Therefore, it is beneficial to combine more compression tests, what will also increase the validity of testing. Other widely used SIJ tests are palpation test, however their validity is poor.