Validity of Physical Exam Maneuvers in the Diagnosis of Sacroiliac Joint Pathology.

Pain Medicine : the Official Journal of the American Academy of Pain Medicine
Byron J SchneiderDavid J Kennedy

Abstract

A combination of physical examination maneuvers is currently considered necessary to help predict who will respond to injections in the sacroiliac joint. However, the literature on this topic currently consists of conflicting studies, with one showing the value of a combination of exam maneuvers and the other showing no real value. To determine the diagnostic validity of sacroiliac joint (SIJ) physical exam maneuvers using anesthetic intra-articular injection as a reference standard. A single institution prospective study. Patients with the clinical diagnosis of SIJ pain and referred for SIJ injection were enrolled. Numeric rating scale (NRS) to assess pain intensity. Participants underwent fluoroscopically guided SIJ intra-articular injection with 1 cc of 2% lidocaine and 1 cc of triamcinolone 40 mg. Patients' pain was assessed via 0-10 NRS pre-injection and immediately postinjection to determine positive anesthetic response to the injection. Six physical exam maneuvers (thigh thrust, Geanslen's test, FABER test, distraction test, compression test, and sacral thrust) were performed pre-injection and 15 minutes postinjection. The results of these SIJ physical exam maneuvers were evaluated singly and in combinations for diagnost...Continue Reading

References

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Jul 17, 2015·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·David J KennedyJohn MacVicar
May 19, 2017·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Byron J SchneiderDavid J Kennedy

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