what pathology does this indicate: disc, spine/bone, or hip
(-) pain with coughing + sneezing
(+) pain with ext/flex
(+) pain w/ PA joint glides
lumbar spine pathology
what pathology does this indicate: disc, spine/bone, or hip
(+) pain w/ coughing + sneezing
sx decrease w/ walking
disc
what pathology does this indicate: disc, spine/bone, or hip
(+) trendelenberg sign
(+) pain or decreased ability to squat
(+) sign of buttock test
hip
4 SI Joint Clearing Tests
- fortin’s sign
- 1* SI joint stress tests: gapping/compression
- TTP at post SI ligaments
- pain/weakness with single leg stance
what is considered a POSITIVE Fortin’s Sign
- within 1cm of PSIS
- 1 finger represents localized pain
- pt consistently points to the same area of SI (one side) over 2+ trials
what are the 4 secondary (2*) SI Joint stress test
- sacral thrust test (PA glide)
- gaenslen’s test
- FABER
- thigh thrust test
what is a positive sacral thrust test
reproduction of concordant symptoms over SI joint and/or posterior ligaments
what is a positive gaenslen’s test
reproduction of concordant pain at SI joint or pubic symphysis
what is a positive FABER test
reproduction of concordant pain over posterior pelvis/buttock
what is a positive thigh thrust test
reproduction of concordant pain at SI joint when ilium moves posteriorly
(+) SI Joint dysfunction clinical prediction rule (CPR)
3+/5 (+) tests from the following
- compression
- distraction
- sacral thrust
- gaeslen test
- thigh thrust
how to perform the pubic stress test?
where does the pt point to their symptoms to lead you to perform this special test?
- one hand has force going caudal + opposite hand going cranial –> apply forces and hold for a few seconds
- anterior hip/pelvis
what does the sign of buttock test indicate
SERIOUS PATHOLOGY
- neoplasm
- fx
- infection
- septic arthritis
how do you perform the sign of buttock test
- passive SLR = (+) pain
- go back to neutral
- passively flex hip AND knee = (+) test when increased pain with no ROM change
4 mobility/functional tests for SI joint
- seated flexion test
- long sitting test (sup –> sit)
- standing flexion test
- gillet’s test
what does the affected side do in a seated/standing flexion test
affected side moves MORE than the other side
what type of innominate does the longer limb have in the long sitting test
posterior
appears short in supine then goes longer in sitting
