More recently, Laslett et al assessed the diagnostic utility of the McKenzie evaluation combined with the following SIJ tests: distraction, thigh thrust, Gaenslen. The SIJ (Sacroiliac joint) Distraction (Colloquially know as Gapping) test is used to of an SIJ sprain or dysfunction when used in the Laslett SIJ Cluster testing. (Laslett et al., ). Conceptually, it seems reasonable to propose that stress testing of the SIJ should provoke pain of SIJ origin. However, clinical stress tests .

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Sacroiliac Joint Dysfunction The evidence favoring the perspective that mechanical SIJ dysfunctions are related to the experience of back and referred pain is less than convincing, despite the volume of papers published on the subject 12 In addition, instability secondary to trauma or childbirth may well be responsible for repeated minor traumas producing, perpetuating, and increasing inflammatory activity in the joint.

I believe Laslett says you do but van der wurff no in this case, but makes sense to take an extra few minutes to perform repeated movements and mobility of hips grind test.

Evidence-Based Diagnosis and Treatment of the Painful Sacroiliac Joint

If I cannot decrease the symptoms with one of these mobilizations, I have to seriously question whether SI path is the problem. A systematic methodological review. The ability to accurately differentiate a diagnosis of sacroiliac joint SIJ pain is clinically important. However, there is already a most illuminating body of research on the subject of back pain, SIJ tests, and sacroiliac joint manipulation. Stuff You Should Read: Selfcare First LLC; This experience was later strengthened during research when it became apparent that in cases with confirmed SIJ pain, the patient commonly reported no change or aggravation after manipulation.


None of the SIJ tests evaluated has any value in identifying the SIJ lesion believed to be treatable by the manipulation. But this is just too simple. In a second laxlett, the data were analyzed in more lasletg against a single block lasltt standard to report on the diagnostic accuracy of composites of pain provocation SIJ tests.

Sacroiliac Joint Special Test Cluster – Physiopedia

The authors found that:. Laslett et al [5] further investigated the diagnostic power of pain provocation sacroiliac joint SIJ tests individually and in various combinations, in relation to a diagnostic injection. Note, this is not to start a debate on the mechanisms of MDT, merely just using it as a classification! lalett

A continued hot topic is classification of low back pain. Reference Standard Reference standard identical to index test but carried out on every subject by independent and blind assessor Independent blind comparisons with Gold standard No gold standard used but assessors independent and blind of each other.

When both the prevalence of the disorder and the results of a test are known, likelihood ratios permit calculation of the change in odds and probability of a disorder being present or absent Its usefulness in evaluating and treating referred pain. Nevertheless, PTs for years have gotten good results from such a treatment approach. A test is positive if it reproduces the patient’s symptoms. I should also add here, that SIJ provocation tests appear morphologically confounded, that is, they may challenge other potential pain generating tissues in addition to the purported structure of interest.

Finally, the knowledge of pain by itself is helpful but can be dangerous if treatment paradigms are designed based on this. This is a particularly interesting article to read if you have interest in this area.


But a good place to start your journey is with the current concepts published by the Orthopedic section of the APTA. The content on or accessible through Physiopedia is for informational purposes only. SIJ Pain Mapping 5.

Intertester reliability for selected clinical tests of the sacroiliac joint. That will work for MOST patients.

I highly agree that you need to rule out the lumbar spine and hips prior to really feeling confident that symptoms are arising from SIJ. Good research lasleft out on a very difficult region.

Prior to any examination, the probability of a given disorder being present is its prevalence.

Evidence-Based Diagnosis and Treatment of the Painful Sacroiliac Joint

Clustering individually unreliable tests may improve reliability but lasltt lacks face validity. A randomized controlled trial. Those who consider the clinical examination as either useless or of minimal utility and demand only the reference standard of diagnosis, i. Toggle navigation p Physiopedia. Little, Brown and Company; These individuals generally have a physical therapy, chiropractic, osteopathic, or manual medicine background.

Sacroiliac Joint Special Test Cluster

IASP’s three diagnostic criteria were:. In laslett original study, it is clear that the authors were searching for a clinical SIJ syndrome. Dysfunction can indicate hypomobility, hypermobility or poor movement patterns about the joint. Stuge et al compared specific stabilization exercises with individualized physical therapy without stabilization exercises in post-partum women with PGP.

That is usually the journal article where the information was first stated. Thanks for the post and starting the discussion.