Sacroiliac Joint Dysfunction
Physical Findings & Clinical Presentation
- Tenderness directly over the PSIS
- Lower Lumbar pain occurs in 72% of cases
- Radiating pain:
- over the buttocks (94% of cases)
- Down the posterior-lateral thigh (50%)
- Past the knee to the ankle (14%)
- Lateral foot (8%)
- Groin or pubic pain in 14% of cases (click for more information)
- Anterior thigh pain in 10%
Special Tests
- FABER or Patrick’s Test (see video below)
- Anterior gapping of SIJ
- Posterior gapping of SIJ
- Forward Bending in Standing Test
- Ipsilateral Hip Flexion Test in Standing
- Test for Form Closure
- Test for Force Closure and Motor Control (ASLR)
- Pubic Stress Test
- Sacrotuberous Ligament Stress Test
- Sacral Compression Test
- Rotational Stress Test
- Gaenslen’s Test
- Yeoman’s Test
Red Flags Associated with SI Symptoms
- History
- Sacroiliac/sacral pain without a history of trauma or overuse (rule out assault, anal intercourse)
- Previous history of cancer
- Previous history of gastrointestinal disease (ulcerative colitis, Crohn’s disease, irritable bowel syndrome)
- Risk Factors
- Osteoporosis
- Sexually transmitted infection
- Long-term use of antibiotics (colitis)
- Clinical Presentation
- Lack of objective findings
- Anterior pelvic, suprapubic, or low abdominal pain at the same level as the sacrum
- Associated signs and symptoms
- Pain relieved by passing gas or having a bowel movement
- Presence of gastrointestinal, gynecological, or urologic signs and symptoms
- When to refer:
- If the condition suspected is not of musculoskeletal origin or if several of the red flags or risk factors are present, refer to a physician.