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Ortho tests > SIJ > Flashcards

SIJ Flashcards

1
Q

What does marching test test for

A

SI or pubic joint strain, fracture

Hypermobility, joint dysfunction
Ipsilateral SIJ dysfunction

Rotation of nominate bone on sacrum

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2
Q

Marching test technique

A

Pt standing, hand on wall
Examiner palpates PSIS and S2 SP
Pt instructed to flex ipsilateral hip to 90- ipsilateral hip flexion, thumbs move together
Examiner observes/palpates motion of PSIS relative to S2
Examiner then instructs the Pt to flex contralateral hip to 90- contralateral hip flexion, thumbs move apart
Examiner observes/palpates motion of S2 relative to PSIS
Normal motion should move S2 away from PSIS
Repeat test on contralteral SIJ

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3
Q

+ve Marching test

A

Localised P- SIJ or pubic Jt sprain, pelvic #

Excess motion- hypermobility, Jt dys
Decreased ROM- ipsilateral SIJ dys

Lack of thumb movement indicates Jt fixation

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4
Q

Marching test clinical notes

A

Can modify this test by palpating the PIIS and sacral apex or S2 SP + ischial tuberosity to evaluate the lower SIJ separatley

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5
Q

What does flamingo test for

A

Ipsilateral SIJ dysfunction

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6
Q

Flamingo technique

A

Pt standing on one leg
Can ask P to hop to increase symptoms
Observe signs of discomfort or P

By standing on one leg pressure is increased on ipsilateral hip, SIJ and pubis symphysis

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7
Q

+ve Flamingo

A

Localised P
P in pubis symphysis + SIJ= lesion in whichever structure is painful

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8
Q

What does Gaenslen’s test for

A

SIJ sprain, instability

Iliopsoas contracture
Lsp or hip pain origin

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9
Q

Gaenslen technique

A

Screening
Pt to edge of couch
Hold leg towards chest
Drop other off couch
Apply pressure to knee and flexed leg, to produce shearing of SIJ

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10
Q

+ve Gaenslen

A

SI or ant thigh P- SIJ Jt patho (lig sprain, instability)

Elevation of extended hip, no SIJ pain- iliopsoas contracture

P may be due to ipsilateral SIJ lesion, hip pathology or L4 N root lesion

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11
Q

What does thigh thrust test for

A

SIJ or hip pathology

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12
Q

Thigh thrust technique

A

Hold leg to chest
Hand under sacrum/SIJ
Apply force down through knee + hip

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13
Q

+ve Thigh thrust

A

P in SIJ- SIJ patho
Hip P- hip Jt patho

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14
Q

Thigh thrust sens

A

80-93

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15
Q

Thigh thrust spec

A

69-100

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16
Q

What does compression test for sij

A

SIJ posterior ligs, fracture, SIJ dysfunction

SIJ instability

17
Q

Compression technique

A

Pt on side
Find ASIS + PSIS, apply contact medially
Apply force down through

18
Q

+ve Compression

A

P- SI sprain/strain, fracture, SIJ dys
Reduced P- SI instability (instability is also indicated if Pt stands with feet wide apart + P is reduced, abducted hips inc SIJ compression and pelvic stability)

19
Q

What does distraction test for

A

Ant SIJ or pubic Jt sprain, fracture
Test L+R SIJ simultaneously

20
Q

Distraction technique

A

Contact on both ASIS
Push outwards + down
Low couch, lean weight on to Pt

21
Q

+ve Distraction

A

Localised P

22
Q

What does sacral thrust test for

A

SIJ dysfunction

23
Q

Sacral thrust technique

A

Pt on front
No pillow under pelvis
Find apex of sacrum
Hands point towards head, flat on sacrum, reinforce with other hand
Apply force anteriorly

24
Q

+ve Sacral thrust

A

P in SIJ
Rotational shift of SIJ produces shearing of sacrum on ilium

25
Q

Active SLR procedure

A

Pt supine
Examiner instructs Pt to lift affected leg 15cm off table
If movement= P examiner stabilises pelvis by compressing over ASIS + asks Pt to repeat movement

26
Q

Active SLR interpretation

A

Inability to raise leg or P with pelvic stabilisation= pelvic #
No P with SIJ stabilisation= sacrioilliac lesion

27
Q

Active SLR clinical notes

A

Test may be more sensitive in Pts with SIJ P during pregnancy

28
Q

Seated flexion test procedure

A

Pt seated
Examiner locates the PSIS bilaterally
If one PSIS is higher than other Pt instructed to lean forward

29
Q

Seated flexion test interpretation

A

Lower PSIS becomes higher with forward flexion= SIJ dys, abnormality in torsion movement

P with forward flexion- SIJ dys

30
Q

Seated flexion test, false +ve

A

Potential for anatomical variation in ilium size + shape that may result in false +ve

31
Q

Seated flexion sens

A

69

32
Q

Seated flexion spec

A

98

33
Q

PSIS asymmetry procedure

A

Pt standing or seated
Examiner compares PSIS height and symmetry
Iliac crest height should be assessed at same time

34
Q

PSIS asymmetry interpretation

A

Standing or seated asymmetry= SI lesion, anatomical variation in osseous structure size and shape

35
Q

PSIS asymmetry clinical notes

A

Test may indicate pelvic rotation with an anterior ilium having a less prominent PSIS

36
Q

Trendelenburg test procedure

A

Pt standing is instructed to lift one leg off the ground
Examiner observes for hip motion from behind

37
Q

Trendelenburg interpretation

A

Pelvic lateral tilt- weak hip abductor muscles (esp glute med), neuro or muscle conditioning deficit
Sens- 73
Spec- 77

P in SI on support leg- SI patho
Sens- 7-19
Spec- 98-100

38
Q

False +ve trendelenburg

A

10% of Pts with hip P will demonstrate a false +ve- muscle weakness due to P

Ortho tests (15 decks)

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