Execution
- 1Position the patient supine on a firm table.
- 2Place both hands on the patient’s anterior superior iliac spines.
- 3Cross the forearms or keeps the arms uncrossed according to comfort and leverage.
- 4Apply a posterolateral force down and outward through both ASISs.
- 5Ask whether the force reproduces the patient’s familiar posterior pelvic, buttock, or posterior leg pain.
Positive outcome
The test is positive only if the patient’s familiar unilateral gluteal or posterior leg pain is reproduced. Magee describes the force as stressing the anterior sacroiliac ligaments. General anterior pelvic pressure or discomfort alone is not a true positive.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Laslett et al. (2005) | test-retest κ = 0.46 | 60 | 81 | 3.20 | 0.49 |
| Broadhurst & Bond (1998) | NA | 23 | 98 | NA | NA |
CommentDistraction is one of the Laslett SIJ provocation tests and has better clinical value as part of a cluster than as a singleton. Magee’s eAppendix shows variable sensitivity across studies, from 23% to 60%, while specificity is generally higher. Use reproduction of familiar posterior pain, not just pelvic pressure, as the decision point.
Moderate Clinical Value