Sacroiliac Compression Test

Sacroiliac Compression Test (or Posterior Sacroiliac Joint Stress Test) is a provocative test used to evaluate the sacroiliac joint dysfunction.

The test also indirectly assesses the ability of the sacrum to counternutate.

How do perform the Sacroiliac Compression Test?

Sacroiliac Compression Test is done with patient side-lying, affected side up, with hips flexed approximately 45 degrees and knees flexed approximately 90 degrees, examiner applies a force vertically downward on the anterior superior iliac crest, the stress is maintained for 30 seconds once an end-feel is obtained.

See Also: Sacroiliac Stress Test

This test can be done with the patient in the supine position, where the clinician, standing behind the patient, applies a medial force to both innominates, using both hands, the stress is also maintained for 30 seconds once an end-feel is obtained.

The procedure creates a medial force that tends to gap the posterior aspect of the sacroiliac joint, while compressing its anterior aspect.

What is a positive SI compression test?

The reproduction of pain over one or both of the sacroiliac joint is considered a positive test.

The posterior (dorsal) SI ligament, which is accessible just below the posterior inferior iliac spine, should be palpated for tenderness.

Accuracy

A study on 48 patients with chronic lumbopelvic pain referred for sacroiliac joint injection, found the sensitivity of 69% a specificity of 69% for this test (in this study, 80% pain relief with injection of local anesthetics into sacroiliac joint).

Population	Reference Standard	Sens	Spec	+LR	-LR
40 patients with chronic low back pain	Sacroiliitis apparent on MRI	.22	.83	1.37	.92
60 patients with chronic low back pain referred to pain clinic	50% pain relief with injection of local anesthetics into sacroiliac joint	.60	.70	2.0	.57

References

1. Chi B. Sacroiliitis. In: Warfield CA, Fausett HJ, editors. Manual of Pain Management. 2nd ed. Lippincott Williams and Wilkins; Philadelphia, PA: 2002. pp. 95–98.
2. Magee DJ. 4th ed. Philadelphia, PA: Saunders Elsevier; 2006. Orthopedic Physical Assessment; pp. 642–643.
3. 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;10:207-218.
4. Ozgocmen S, Bozgeyik Z, Kalcik M, Yildirim A. The value of sacroiliac pain provocation tests in early active sacroiliitis. Clin Rheumatol. 2008;10: 1275-1282.
5. van der Wurff P, Buijs EJ, Groen GJ. A multitest regimen of pain provocation tests as an aid to reduce unnecessary minimally invasive sacroiliac joint procedures. Arch Phys Med Rehabil. 2006;87:10-14.
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7. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.
8. Netter’s Orthopaedic Clinical Examination An Evidence-Based Approach 3rd Edition Book.