Pain provocation tests for diagnosis of sacroiliac joint pain.

There are many tests devised to provide information about sacroiliac joint (SIJ) pain and function. Only pain provocation SIJ tests have been shown to have satisfactory inter-examiner reliability and validity with respect to a meaningful reference standard. These tests apply stress to the SIJ to determine if the usual pain is produced or aggravated and have been described in the orthopaedic medicine literature over many decades. Cyriax (1975) was probably the first author to include some in a comprehensive examination schema. Although not all provocation SIJ tests have been subjected to good quality reliability and validity research, the distraction, thigh thrust, Gaenslen’s, compression, sacral thrust, and Patrick’s tests are fully described (Kokmeyer et al 2002, Laslett et al 2003) and good clinimetric data are available.