Distraction test of the posterior superior iliac spine (PSIS) in the diagnosis of sacroiliac joint arthropathy

BMC Surgery

Georg Osterhoff¹  Hans-Peter Simmen¹  Matthias A König¹  Lucienne Gautier¹  Armando Hoch¹  Clément M L Werner¹ 

[1] Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, Zurich 8091, Switzerland

关键词: Diagnostic value;    Joint infiltration;    Provocation test;    Sacroiliac joint pain;   

Others  :  1123296
DOI  :  10.1186/1471-2482-13-52

 received in 2013-07-15, accepted in 2013-10-25,  发布年份 2013

【 摘 要 】

Background

The sacroiliac joint (SIJ) is a frequently underestimated cause of lower back (LBP). A simple clinical test of sufficient validity would be desirable. The aim of this study was to evaluate the diagnostic value of a new PSIS distraction test for the clinical detection of SIJ arthropathy and to compare it to several commonly used clinical tests.

Methods

Consecutive patients, where a SIJ pathology had been confirmed by an SIJ infiltration were enrolled (case group, 61 SIJs in 46 patients). Before infiltration, patients were tested for pain with PSIS distraction by a punctual force on the PSIS in medial-to-lateral direction (PSIS distraction test), pain with pelvic compression, pelvic distraction, Gaenslen test, Thigh Thrust, and Faber (or Patrick’s) test. In addition, these clinical tests were applied to both SIJs of a population of individuals without history of LBP (control group, 64 SIJs in 32 patients).

Results

Within the investigated cohort, the PSIS distraction test showed a sensitivity of 100% and a specificity of 89% for SIJ pathology. The accuracy of the test was 94%, the positive predictive value (PPV) was 90% and the negative predictive value (NPV) was 100%. Pelvic compression, pelvic distraction, Gaenslen test, Thigh Thrust, and Faber test were associated with a good specificity (> 90%) but a poor sensitivity (< 35%).

Conclusions

Within our population of patients with confirmed SIJ arthropathy the PSIS distraction test was found to be of high sensitivity, specificity and accuracy. In contrast, common clinical tests showed a poor sensitivity. The PSIS distraction test seems to be an easy-to-perform and clinically valuable test for SIJ arthropathy.

【 授权许可】

   
2013 Werner et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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