lab 4: SIJ examination and interventions Flashcards
what is the order of examination
- pt hx
- systems review
-observation - UQ/ LQ scanning exam
-AROM ,PROM , flexibility - muscle performance
- joint play
- palpation
-special test
if during observations ur patient says that have pain with sitting to standing or vise versa .. pian with transitional movements then what would we suspect
SIJ dysfunction
if a pt has a flatten spine what is possible, what is short adn weak
Possible stenosis, lateral shift, disc herniation
Short hamstrings, weak hip flexors
if a pt has excessive lordosis what is possible and what is short and weak
- Possible pelvic crossed syndrome
- Short ES and hip flexors, core and hip ext weak
if a pt has swayback what does that mean
- Thoracic kyphosis + posterior
pelvic tilt - Hips hyperextended
what signs would suspect a lumbar disc pathology
- (+) pain w/ coughing and sneezing (bc increase pressure in interthecal)
- Sx ↓ w/ walking (bc extension makes it feel better)
what are the signs that are present that would make us think lumbar spine joint pathology
- (-) pain w/ coughing and sneezing (bc its not invovled within in SC)
- (+) pain w/ extension or flexion
- (+) pain w/ PA joint glides (arthokinematic things reproduces symptoms)
what signs are presents that would make use things hip joint
- (+) Trendelenberg sign
- (+) pain or ↓ ability to squat
- (+) sign of buttock test
what 4 things could proceed us to do a full SIJ exam if they are positive
- • Fortin’s sign
• 1o SI joint stress tests: gapping or
compression
• TTP at post SI ligaments
• Pain/weakness w/ SLS
what is Fortin’s Sign
patient localizes pain w 1 finger over PSIS
what are considered the primary SI joint stress test and that are considered the best psychomotor test
Gapping (distraction) test and compression test (painful side up)
both are provocation test bc the SI is a circle
what are the secondary SI joint stress tests (4)
-sacral thrust test (SIJ PA glide)
-Gaenslen’s test
-FABER/Patricks test
-thigh thrust test
what is the sacral thrust test
-patient in prone and u apply significant anterior force at S3 multiple times
- (+): reproduction of concordant symptoms over SI and/or postieor SI ligaments
what is the Gaenslen’s test
Pt is positioned like the thomas test and then the PT apples an extension force on bottom leg and flexion force on top leg
purpose is to anterior rotate 1 ilium and postieor rotate the other one
leg being tested is the bottom leg
- (+)= reproduction of concordant pain at SIJ or pubic symphysis
what is the FABER/ Patricks test
put patient in flexion, abduction and ER
screen for lumbar , SIJ and hip path
if no symptoms then add over pressure
(+)= reproduction of concordant pain over postieor pelvis/ buttocks *SIJ dysfunction
what is the thigh thrust test
- pt on back and therapist put hand under sacrum to stabilize it and then puts pt into 90° of HF and then push down thru the femur to cause a posterior translation on the innomiante on the sacrum
(+)= reproduction of concordant pain in SIJ
what is the (+) SI joint dysfunction clinical prediction rules
- Compression
- Distraction
- Sacral thrust
- Gaeslen test
- Thigh thrust
** IF 3 OR MORE OUT OF THE 5 TEST ARE (+) THEN WE THINK SIJ DYSFUCTION
what is the (-) SI joint dysfunction clinical prediction rules
- Compression
- Distraction
- Gaeslen test
- FABER
- Thigh thrust
IF 3 OR LESS OUT OF THE 5 TEST ARE (+) THEN WE THINK NO SIJ DYSFUNCTION
what stress test do u do for pubic symphysis pain
pubic stress (superior inferior) test for anterior pain
what is the sign of buttock test , what does it indicate and how do u do it
use if u are looking for NON MSK things
indicated serious pathology like neoplasm , fx, infection , septic arthritis
produced
- do passive SLR = (+) for pain
- retunr leg to neutral
- passively flex hip w knee flexed to take out the sciatic nerve and it is (+) if increase pain w no change in ROM then we think something serious
what are the 4 MOBILITY/FUNCTIONAL test for special test for SIJ dysfunction
- seated flexion test
-standing flexion test
-supine to long sit (long sitting test)
-gillet’s (stork) test
what is the seated flexion test
pt is positioned in sitting and PT feels for PSIS and intructs pt to lean foward > PSIS SHOULD move equal distance in SUperior direction
• (+) test = PSIS do not move equal distances w/ affected side moving more than unaffected side
what can the seated flexion test but used to rule out
LE dysfunction such as LLD or hamstring tightness when compared to standing test
when would u do the mobility/fucnitonal special test for SIJ
- (+) CPR
- hypo mobility
- papaltion problems
