SIJ dysfunction

Question 1

(true/false) The SIJ has some movement

Answer 1

true

Question 2

(true/false) The SIJ has the strongest ligaments in the body.

Answer 2

true

Question 3

What are the 3 intraarticular ligaments of the SIJ?

Answer 3

1. anterior SI ligament
2. posterior SI ligament
3. interosseous SI ligament

Question 4

What are the three extraarticular ligaments of the SIJ?

Answer 4

1. sacrotuberous
2. sacrospinous
3. iliolumbar

Question 5

If a patient has pain on the superior aspect of their ischial tuberosity, what is indicated?

Answer 5

Inflammed sacrotuberous ligament

Question 6

If a patient has pain on the inferior aspect of their ischial tuberosity, what is indicated?

Answer 6

hamstring pathology

Question 7

What is the most common SIJ ligament to be injured?

Answer 7

sacrospinous

Question 8

If a patient is TTP in the L5 region, this can be an indication of inflammation to what ligament?

Answer 8

iliolumbar ligament

Question 9

How many muscles attach to the SIJ?

Answer 9

35 muscles

Question 10

What is the common patient history of SIJ dysfunction?

Answer 10

Females>Males

Can be seen with any age

Very common post-partum (50%)

Pain reported w/ sit-stand transfers, rolling, prolonged sitting (esp slouch sitting) and/or standing

Relief with movement, stretching

Unilateral pain located distal to L5

Can refer to lateral buttock (most common), groin, anterior thigh, posterior thigh, PSIS, pubic symphysis, or distally into LE.

Can sometimes be result of traumatic MOI (fall, slip on ice, MVA with foot on brake, heavy lifting) or benign MOI such as sitting cross-legged on floor and reaching to the side (often post-partum when playing with baby)

Symptoms most often proximal to knee

Question 11

(true/false) Certain non-MSK conditions can manifest in the SIJ as a primary site.

Answer 11

true

Question 12

What is a typical physical exam for a patient with SIJ dysfunction?

Answer 12

No centralization or peripheralization of symptoms with lumbar AROM/ repeated movement testing

(+) Fortin Finger Sign with (-) Tuber’s Sign

May show (+) Active SLR, (+) FABER Test for PSIS or lateral hip/buttock pain
(-) Faber when SIJ is stabilized

(+) Trendelenburg Test or decreased unilateral SLS time on symptomatic side

No Motor Weakness, DTR changes, or LMN signs

> 3/5 (+) tests of Laslett’s 5 test cluster

Question 13

What TBC is most commonly indicated for SIJ dysfunction?

Answer 13

manipulation/mobilization
stabilization

Question 14

What test in Laslett’s cluster is the most sensitive?

Answer 14

Thigh thrust

Question 15

What test in Laslett’s cluster is the most specific?

Answer 15

Distraction test

Question 16

Those with SIJ dysfunction can see asymmetry in ____ and ___ ROM.

Answer 16

ER/IR

Question 17

What are specific pain-provoking positions for SIJ dysfunction?

Answer 17

tailor sitting
side sitting
crossing legs
prolonged static postures