Execution
- 1Position the patient standing with equal weight through both feet.
- 2Palpate both posterior superior iliac spines with the thumbs.
- 3Ask the patient to bend forward slowly from standing.
- 4Observe and palpate the relative superior movement of each PSIS during trunk flexion.
- 5Record the side that moves first or moves farther superiorly.
Positive outcome
The traditional positive finding is asymmetric PSIS motion, usually the PSIS on the dysfunctional side moving earlier or farther superiorly during forward flexion. The finding is intended to suggest SIJ movement dysfunction. It should not be used as a standalone diagnostic test.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| van der Wurff et al. (2000) — systematic review | NA | NA | NA | NA | NA |
| Ribeiro et al. (2021) — systematic review and meta-analysis | NA | NA | NA | NA | NA |
CommentStanding flexion is a classic SIJ motion palpation test, but modern evidence does not support it as a reliable standalone diagnostic tool. Palpation error, body habitus, hamstring length, lumbar motion, and patient strategy can all change the apparent PSIS movement. Keep it as a historical movement screen only.
Low Clinical Value