Execution
- 1Position the patient in the position required to monitor sacral and innominate motion, usually prone or side-lying depending on the chosen manoeuvre.
- 2Palpate the sacrum and ilium close to the sacroiliac joint.
- 3Guide the innominate into a movement that should encourage sacral nutation or anterior rotation of the ilium.
- 4Compare relative sacrum-on-ilium movement with the opposite side.
- 5Record whether movement is reduced, painful, or asymmetrical.
Positive outcome
Reduced relative movement, pain over the SIJ, or marked asymmetry compared with the opposite side is considered abnormal. Magee describes nutation as a small motion in which the sacrum moves down and then posteriorly along the sacroiliac joint surfaces. Because the motion is very small, palpatory interpretation is uncertain.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| van der Wurff et al. (2000) — systematic review | NA | NA | NA | NA | NA |
| Sturesson et al. (2000) — radiostereometric motion study | NA | NA | NA | NA | NA |
CommentNutation testing is based on a biomechanical model of tiny SIJ motion, not on strong clinical diagnostic-accuracy evidence. Magee’s anatomy section notes that SIJ movement is slight, especially with age and joint-surface irregularity. This should remain a low-value impairment observation unless corroborated by stronger clinical findings.
Low Clinical Value