Special Orthopedic Tests : Pelvis

Question 1

SI Compression Test

Answer 1

Process :
1. Client prone
2. Examiner applies downward pressure over SI joint, one side at a time
+ve Sign : Pain at SI joint
+ve Indicates : Sprain of anterior sacroiliac ligaments

Question 2

Approximation (Transverse Posterior Stress) Test

Answer 2

Process :
1. Client sidelying
2. Examiners hands are placed over upper part of iliac crest, pressing toward the floor
+ve Sign : Increased feeling of pressure & pain at SI joint
+ve Indicates : Sprain of posterior sacroiliac ligaments

Question 3

Gapping (Transverse Anterior Stress or Distraction Provocation) Test

Answer 3

Process :
1. Client supine
2. Examiner applies crossed arm pressure to the ASIS’s, pushing down & out
+ve Sign : Unilateral gluteal or posterior leg pain
+ve Indicates : Sprain of anterior sacroiliac ligaments

Question 4

Prone Gapping (Hibb’s Test)

Answer 4

Process :
1. Patient prone
2. Examiner stabilizes pelvis & palpates SI joint
3. Patient’s knee flexed 90 degrees & hip maximally medially rotated
4. Examiner compare’s degree of opening & movement quality
+ve Sign : Reproduction of the patient’s symptoms
+ve Indicates : SI joint pathology (posterior SI ligaments)

Question 5

“Squish” Test

Answer 5

Process :
1. Client supine
2. Examiner places both hands @ ASIS’s & iliac crest
3. Pushes down & in @ 15 degree angle
+ve Sign : Pain at SI joint
+ve Indicates : Sprain of posterior sacroiliac ligaments

Question 6

Thigh Thrust Test (Oostagard, 4P, Sacrotuberous Test, or POSH [Posterior Shear] Test)

Answer 6

Process :
1. Patient supine; examiner passively flexes hip 90 degrees
2. Using one hand to palpate SI joint, examiner thrust down through knee and hip
+ve Sign : Pain at SI joint on thrusting
+ve Indicates : Sprain of posterior sacroiliac ligaments

Question 7

Supine Active Straight Leg Raise Test (aSLR)

Answer 7

Process :
1. Client supine & actively flexes one hip at a time keeping rest of leg straight
2. If client notes pain or “effort difference” examiner stabilizes & compresses pelvis & client repeats hip flexion
+ve Sign : Pain decrease or SLR is easier to perform
+ve Indicates : SI joint hypermobility

Question 8

Flamingo Test or Maneuver

Answer 8

Process : Patient asked to stand on one leg
+ve Sign : Pain in symphysis pubis or standing leg SI joint
+ve Indicates : Lesion in pubic symphysis or SI joint

Question 9

Gaenslen’s Test

Answer 9

Process :
1. Client sidelying, holds bottom leg against chest
2. Examiner stabilizes pelvis & hyperextends top leg
+ve Sign : Pain
+ve Indicates : SI joint lesion, or hip pathology

Question 10

Gillet’s (Sacral Fixation) Test

Answer 10

Process :
1. Client stands as examiner palpates test side PSIS & S2 SP (parallel with PSIS)
2. Client asked to lift one knee toward chest & then the other
+ve Sign : SI joint moves minimally or moves superior
+ve Indicates : Hypomobile sacroiliac joint

Question 11

Trendelenburg Test or Sign

Answer 11

Process :
1. Client asked to balance on one leg & then the other
2. Examiner observes movement of the pelvis
+ve Sign : Pelvis on nonstance leg falls
+ve Indicates : Hip abductor weakness/instability