Pelvis

Sacroiliac joint related pain

Mechanism

Pain arising from the sacroiliac joint, usually from disturbed load transfer between trunk and leg. Pregnancy, a fall onto the buttocks and asymmetric loading are the usual triggers.

Recognition

Pain around the PSIS that the patient can indicate with one finger, and three or more positive tests from Van der Wurff's cluster. The ASLR shows whether pelvic compression reduces the complaint.

Course

Individual SI tests say little; only the cluster approaches the reliability of a diagnostic block. Always rule out a lumbar cause first, because it can make the same tests positive.

Structures

• Sacroiliac and iliolumbar ligament complex
• Sacrum
• Hip bone

Joints involved

• Sacroiliac joint

Clinical tests

• Van der Wurff test cluster
• Active straight leg raise
• Thigh thrust
• Laslett's cluster

Sources

• Magee DJ, Manske RC. Orthopedic Physical Assessment, 7e editie. Elsevier. 2021