Sacroiliac joint special test.pptx

Physiotherapists utilize sacroiliac joint special tests to diagnose pain or dysfunction within the joint connecting the sacrum and ilium in the pelvis. These tests focus on specific movements or palpation techniques that provoke discomfort or uncover irregularities in the joint. Common assessments like Gaenslen's, FABER, and the compression test aid in evaluating pain response, joint mobility, stability, and integrity. By identifying sacroiliac joint issues through these tests, physiotherapists can tailor treatment plans to alleviate pain and restore functionality for their patients.

1. SACROILIAC JOINT SPECIAL TEST

2. Thigh Thrust Test Gaenslen's Test Gapping test Knee to shoulder test Straight leg raise test Flamingo test Leg length test 90–90 Straight leg raise test Patrick test Trendelenburg test

3. Thigh Thrust Test The patient lies supine while the examiner passively flexes the hip on the test side to 90°. Using one hand to palpate the sacroiliac joint, the examiner thrusts down through the knee and hip on the test side. Pain in the sacroiliac joint on thrusting is a positive test.

4. Gaenslen's Test The patient lies on the side with the upper leg (test leg) hyperextended at the hip. The patient holds the lower leg flexed against the chest. The examiner stabilizes the pelvis while extending the hip of the uppermost leg. Pain indicates a positive test. The pain may be caused by an ipsilateral sacroiliac joint lesion, hip pathology, or an L4 nerve root lesion. It can also performed In supine position.

5. Gapping test Patient In supine lying position. Examiner give cross arm pressure to ASIS. Pressure will be down and out. posterior leg pain is produced, indicating a sprain of the anterior sacroiliac ligaments. Care must be taken when performing this test. The examiner’s hands pushing against the ASIS can elicit pain, because the soft tissue is being compressed between the examiner’s hands and the patient’s pelvis.

6. Knee to shoulder test Also called as sacroiliac rocking test The Sacrotuberous Ligament Stress Test, patient in a supine position, involves the examiner fully flexing the patient’s knee and hip, followed by adduction. Basically knee to opp. Shoulder. Pain in SI Indicate positive SI dysfunction. Palpate sacrotuberous ligament for tenderess .

7. Straight leg raise test Patient-supine. while the examiner lifts one extended leg. Starting with the hip in a neutral position, the examiner slowly raises the leg until the patient experiences pain in the back or leg. Typically, the leg is lifted to around 30-70 degrees. It evaluate nerve root pathology it can be lumbar nerve impingement, disc herniation, or other nerve-related issues.

8. Flamingo test Position: stand on one leg. the weight of the trunk causes the sacrum to shift forward and distally with forward rotation. The ilium moves in the opposite direction. On the non–weight-bearing side, the opposite occurs, but the stress is greatest on the stance side. Pain in the symphysis pubis or sacroiliac joint indicates a positive test. The stress may be increased by having the patient hop on one leg.

9. Leg length test it is vital when suspecting a sacroiliac joint issue. To measure true leg length, the patient lies supine with leveled ASISs and perpendicular lower limbs to that line. Using a flexible tape measure, the examiner gauges the distance from each ASIS to the respective medial malleolus and compares the measurements. Normally, a 1 to 1.3 cm difference is acceptable.

10. 90–90 Straight leg raise test In supine position, the patient flexes both hips to 90° while the knees will be bent, stabilizing knees with hands. Actively extending each knee individually gauges hamstring flexibility. Typically, for normal hamstring flexibility, the knee extension should be within 20° of full extension. A measurement less than 125° signifies tight hamstrings. Muscle stretch typically characterizes the end feel during this test.

11. Patrick test also known as Jansen's test and figure of 4, initiates from the Flexion, Abduction, and External Rotation (FABER) position at the hip. supine position, the examiner places the patient's test leg so that the foot rests on the opposite knee. then examiner slowly lowers the test leg toward the examination table. negative test- leg's knee touches the table or aligns parallel to the opposite leg. positive test- if the test leg's knee remains above the opposite straight leg, suggesting potential hip joint, iliopsoas spasm, or sacroiliac joint involvement

12. Trendelenburg test in this test, the patient stands or balances on each leg while the examiner observes pelvic movements. When the pelvis rises on the non-stance leg side, it's negative as the gluteus medius muscle on the stance side elevates it, which is a typical response. Conversely, if the pelvis falls on the non-stance leg side, the test is considered positive, indicating potential weakness or instability in the hip abductor muscles, particularly the gluteus medius on the stance side.

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