Pelvis and hip tests Flashcards
SI Joint Provocation test package
SI Distraction Test SI Compression Test Thigh Thrust Test Gaenslen’s Test Sacral Thrust Test
3 or more:
(+) LR of 4.29 - 6.97
Sensitivity .94
Specificity .78
SI Distraction Test
Positioning:
v1: patient supine, place hands over ASISs
v2: patient supine, cross arms and place hands over ASISs
Instruction: let me know how this feels
Technique: apply force straight down … shearing
Interpretation: positive is reproduction of pain.
v1: ANTERIOR SI joints are stressed
v2: POSTERIOR SI joints are stressed.
SI Compression Test
Positioning: patient side-lying (bad side exposed)… hips and knees slightly bent for support. stack both hands btwn the greater trochanter and iliac crest
Instruction:let me know how this feels
Technique: press straight down toward the table
Interpretation: positive is reproduction of pain. SI joint is stressed.
Thigh Thrust Test
Positioning: patient supine with hip flexed to 90 deg, knee flexed and hip slightly adducted to mimic the plane of the SI joint
Instruction: let me know how this feels
Technique: apply force with both hands straight down through the femur. two stages of resistance encountered: first is head of femur against capsule, second is moving the whole innominate
Interpretation: positive is reproduction of pain.
Gaenslen’s Test
Positioning: patient supine w/ SI joint near edge of table. Opposite knee to chest … low back flat on table, testing side leg hanging off.
if testing patient’s right side: stand on the right side. left hand helping hold their knee/hip in flexion, right leg pressing up under their calf to keep foot off the floor, right hand on their right knee.
Instruction: let me know how this feels
Technique: apply downward pressure on the leg to extend the hip and stress the SI joint. looking for 10-30 degrees of movement.
Interpretation: positive is hip extension THEN SI joint movement reproducing pain. will be felt POSTERIORLY. any number of things can cause anterior pain.
Sacral Thrust Test
Positioning: patient prone. place one hand on sacrum with fingers pointing up toward head. stack the other hand on top.
Instruction: let me know how this feels
Technique: downward force straight down in three increasingly forceful stages. finishing thrust on the third stage.
Interpretation: positive is reproduction of pain. stressing anterior and posterior SI ligs as well as internal SI joint.
Belt test
Positioning:
part 1: patient standing
part 2: stand behind patient stabilize sacrum against lateral thigh, stabilize pelvis by grasping bilateral ASIS and iliac crests
Instruction:
part 1: reach for your toes
part 2: reach forward again as far as you can
Technique:
part 1: observe
part 2: observe
Interpretation:
part 1: pain could be SI or lumbar
part 2: if pain is still present with SI joint stabilized, movement of the lumbar spine is what’s causing pain.
Yeoman’s test
Positioning: patient prone. passively flex the knee to 90, and hold the medial aspect of the knee (shin will rest in the crook of your arm). stabilize SI joint with the other hand.
[if testing patient’s left side, stand on their left, stabilize sacrum with left hand and manipulate leg with your right]
Instruction: stay relaxed, let me know what you feel.
Technique: lift the knee to extend the hip at least 10 deg. keep lifting until you feel the pelvis roll (then it’s too far)
Interpretation: less than 10 deg motion (acetabulofemoral joint) makes walking properly difficult which can lead to SI trouble.
FABERE (Patrick’s test)
FABERE: Flexion, ABduction, Ext Rot, Extension
Positioning: patient supine. stand to the side which will be tested, level with the hip
Instruction: let me know what you feel
Technique: put test-side leg in figure 4 position with ankle crossing just above the knee. near hand will press down on the knee to extend the hip, other hand goes to the far ASIS to stabilize.
Interpretation: pain is indicative of some type of hip pathology.
elderly: osteoarthritis, osteoperosis, avascular necrosis
young: avascular necrosis, stress fracture, joint capsule sprain, impingement syndrome
Anvil test
Positioning: patient supine, leg straight and shoes off.
Instruction: let me know if there’s pain
Technique: strike the heel with the base of the hand … light, then moderate, then vigorous.
Interpretation: recreating hip pain from heel strike.
Hip scour test
Positioning: patient supine. stand to testing side.
Instruction: let me know if there’s pain.
Technique: flex the hip and the knee to 90 each.
pre-test: flex, adduct, internally rotate hip. if there’s ANTERIOR hip pain, be more gentle with the test.
test: take the hip to max flexion and completely circumduct it.
Interpretation: head of the femur is traveling all the way around the acetabulum. there might be pain or resistance from thick/tight spots. could be labral tear or ligament sprain.
