The five provocation tests commonly used to assess sacroiliac (SI) joint dysfunction are Gaenslen's test, the thigh thrust test, the distraction test, the compression test, and the sacral thrust test. These tests help determine if pain is originating from the SI joint.
Understanding Sacroiliac Joint Provocation Tests
Sacroiliac joint dysfunction can cause pain in the lower back, hips, or groin. These tests are designed to stress the SI joint to elicit pain and help diagnose a problem. A positive test indicates potential SI joint involvement.
The 5 SI Joint Tests
Here is a closer look at each of the five tests:
Test Name | Description | Purpose |
---|---|---|
Gaenslen's Test | Patient lies on their side with one leg extended off the table and the other flexed to the chest. | Stresses the SI joint by applying a rotational force through the pelvis. |
Thigh Thrust Test | Patient lies supine, and the hip is flexed to 90 degrees. A downward force is applied through the femur. | Places compression and shear forces on the SI joint. |
Distraction Test | Patient lies supine, and the examiner applies outward pressure on the anterior superior iliac spines (ASIS). | Opens or distracts the SI joints and provokes pain. |
Compression Test | Patient lies on their side, and the examiner applies downward pressure to the iliac crests. | Compresses the SI joint, testing for pain. |
Sacral Thrust Test | Patient lies prone, and the examiner applies a direct downward pressure to the sacrum. | Applies a direct force to the sacrum, which can provoke SI joint pain. |
Clinical Significance
- Diagnosis: A positive finding in three or more of these tests increases the likelihood of sacroiliac joint dysfunction.
- Clinical Decision Rule: These tests are used in conjunction with a clinical examination to formulate an accurate diagnosis and develop a treatment plan. The clinical decision rule states that a positive response to at least three out of five of these tests is considered significant for SI joint dysfunction.
- Subjective Interpretation: Patient's pain response is a key component of each test. The examiner will note the location, intensity, and type of pain.
- Imaging Considerations: These tests can not completely diagnose SI joint pain but must be used in conjunction with the patient's history and imaging if needed.
Example of Interpretation
- A patient experiences pain during the thigh thrust, compression, and sacral thrust tests. This indicates a higher probability of SI joint dysfunction.
These tests serve as a key component in the assessment of SI joint pain, helping healthcare professionals accurately diagnose and manage related conditions effectively.