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Special Test

Sacral Thrust Test

The sacral thrust test is a provocative test that is used to evaluate the sacroiliac joint (SIJ) dysfunctions.

How do you perform a sacral thrust test?

The patient is positioned prone on a firm surface, and the clinician stands at the patient’s side. With one hand, the clinician palpates the inferior aspect of the sacrum in the midline (second or third spinous process of the sacrum) and reinforces this hand with the other. The clinician then applies an anterior force at S3 vigorously and repeatedly (up to six thrusts), and the reproduction of symptoms is noted.

See Also: Sacroiliac Compression Test
Sacral Thrust Test
Sacral Thrust Test

What does a positive sacral thrust test mean?

The test is considered positive if pain is reproduced over the sacroiliac joints or the posterior (dorsal) SI ligament, or both.

Sacral Thrust Test diagram

Accuracy

In a study by Laslett and colleagues, this test was found to have a:

  • Sensitivity: 63%
  • Specificity: 75%

This study suggesting that the test provides only marginal diagnostic value when used in isolation.

PopulationReference StandardSensSpec+LR-LR
40 patients with chronic low back pain Sacroiliitis apparent on MRI.33.741.29.89
48 patients with chronic lumbopelvic pain referred for sacroiliac joint injection 80% pain relief with injection of local anesthetics into sacroiliac joint.63.752.5.50
85 consecutive patients with low back pain referred for sacroiliac joint blocks 90% pain relief with injection of local anesthetics into sacroiliac joint.52.83.841.26

References

  1. Lee DG: Clinical manifestations of pelvic girdle dysfunction. In: Palastanga N, Boyling JD, eds. Grieve , s Modern Manual Therapy: The Vertebral Column, 2nd ed. Edinburgh: Churchill Livingstone, 1994:453–462.
  2. Laslett M, Williams M: The reliability of selected pain provocation tests for sacroiliac joint pathology. Spine 19:1243–1249, 1994. THE SACROILIAC JOINT 139
  3. Vleeming A, Pool-Goudzwaard AL, Hammudoghlu D, Stoeckart R, Snijders CJ, Mens JM. The function of the long dorsal sacroiliac ligament: its implication for understanding low back pain. Spine (Phila Pa 1976). 1996 Mar 1;21(5):556-62. doi: 10.1097/00007632-199603010-00005. PMID: 8852309.
  4. Laslett M, Aprill CN, McDonald B, Young SB. Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Man Ther. 2005 Aug;10(3):207-18. doi: 10.1016/j.math.2005.01.003. PMID: 16038856.
  5. Ozgocmen S, Bozgeyik Z, Kalcik M, Yildirim A. The value of sacroiliac pain provocation tests in early active sacroiliitis. Clin Rheumatol. 2008 Oct;27(10):1275-82. doi: 10.1007/s10067-008-0907-z. Epub 2008 May 6. PMID: 18458988.
  6. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.
  7. Netter’s Orthopaedic Clinical Examination An Evidence-Based Approach 3rd Edition Book.
Last Reviewed
January 7, 2024
Contributed by
OrthoFixar

Orthofixar does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice.

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