TESTS OF SACROILIAC JOINT DYSFUNCTION
Sacroiliac joint or SI joint:
Is a synovial joint between sacrum and ilium bones. Joint is stabilized by various muscles and load of axial skeleton to hip bones. It also acts as shock absorber and can perform nutation and counternutation movements.
Provocative Tests of SI joint:
It is non-invasive technique to identify the dis-functioning of SI joint. During this test PT performs specific physical manoeuvre on patient laying in particular way and tries to recreate pain. If pain is recreated it means test is positive. Some very important provocative tests of SI joint are here:
· Distraction Test:
Patient position: supine
Method: Examiner applies vertical force in posterolateral direction on both ASIS.
· Compression Test:
Patient position: Sidelying with hips and knee flexion
Method: Examiner applies vertical force in downward direction on uppermost iliac crest.
· Thigh Thrust\Femoral Shear Test:
Patient position: Supine
Method: Examiner flexes and adducts pt. hip and knee at right angle & places one hand under sacrum and then applies longitudinal force through femur downwards and gives 3 to 6 high velocity thrusts with gradually increasing pressure.
· Gaenslen`s Test:
Patient position: Supine
Method: Examiner flexes hip joint of one side and extends the opposite hip. This maneuver stresses both SI joints simultaneously.
· Patrick`s \Faber\Figure Four Test:
Patient position: Supine
Method: Examiner crosses the affected leg over the knee of opposite leg and stabilizes the opposite ilium and presses the affected leg in downward direction.
· Yeoman`s Test:
Patient position: Supine
Method: Examiner flexes the affected leg of patient then grabs distal femur with one hand and puts pressure on PSIS with other hand then moves thigh into extension.
· Sacral Thrust Test:
Patient position: prone position
Method: Examiner places base of hand on S2 joint then applies 3 to 6 high velocity thrusts.
· Gillet Test:
Patient position: Standing position
Method: Examiner palpates both PSIS, then palpates S2 with one hand while other hand on same place. Then ask the pt. to flex his one leg then examiner can clearly observe that PSIS moves downward.
· Shimpi Prone Test
Patient position: prone position
Method: examiner places one hand under ASIS and ask pt. to extend hip at 15 degrees. If ASIS lifts off the pt. hand and pain arise at spine it means test is positive. If ASIS presses therapist hand and no pain arise it means test is negative.
· Standing Bend Over \Forward Flexion Test
Patient position: Standing position
Method: Examiner palpates both PSIS with thumb and ask the pt. to bend forward and therapist observes his both thumbs. If thumb of one side moves above the other it means test is positive.
If you want to see videos of these tests to understand them accurately then visit this YouTube channel. It will help you to get more info. I mostly prefer this channel to memorize different joints tests as it helps me a lot. So, this might be helpful for you. Thanks…
