Diagnostic Accuracy of Clusters of Pain Provocation Tests for Detecting Sacroiliac Joint Pain: Systematic Review With Meta-analysis

Abstract

Low back pain is one of the most common causes of permanent functional impairment 47 and is recognized as a key cost driver in the medical system. 11 Anatomical structures of the lumbar spine, such as the intervertebral discs, ligaments, facet joints, or musculature, may cause low back pain. 6,7,30,38 However, others view this model of a peripheral pain generator in a critical light and propose other causes of pain, including neurophysiological, psychological, and social factors. 28,42,46

What You Need to Know About Sacroiliac Dysfunction

“…Special tests are manually performed by the healthcare provider to rule in or rule out a particular diagnosis, in this case SIJD, and are part of the clinical examination. Recent and older literature recommends the use of pain-provoking SI joint special tests (Buchanan et al, 2021; Falowski et al, 2020; Laslett, 2019; Saueressig et al, 2021; Vleeming et al, 2008).…”

“…Other researchers include tests such as FABER, Yeoman test, Gaenslen test, Gaenslen modified test (side-lying), as well as “Laslett's cluster” mentioned earlier (Buchanan et al, 2021). Although some ardently advocate for the use of these tests (Buchanan et al, 2021; Laslett, 2019), a recent systematic review of diagnostic tests found that they are better used to rule out SIJD (93% certainty) rather than rule it in (36% certainty) (Saueressig et al, 2021). Other groupings of special tests are still being used by some healthcare providers (anecdotal) and are the movement-based tests, mobility tests of the SI joint, and the static symmetry tests.…”

Sicher klassifizieren – Untersuchung der LWS – die Tests

“…Zur Untersuchung des Iliosakralgelenks werden Provokationstests eingesetzt. Die Zuverlässigkeit und Validität dieser Tests ist noch umstritten 14 . Gut geeignet ist etwa der Provokationstest des SI-Gelenks (Posterior Pelvic Pain Provocation Test, PPPP) ( ABB.…”

Spielt es eine Rolle, ob das ISG als Schmerzquelle diagnostiziert wird?

“…A previous cluster of tests was considered useful for diag nosing pain arising from the SIJ [29]. However, a recent systematic review and meta-analysis suggested the test battery was better used for ruling out the SIJ if negative [30]. The clinician can be left with some uncertainty, how ever, there are some other factors that the clinician may use in their hypothesis formation.…”

“…Bisher wurde ein bestimmter Testcluster für geeignet gehalten, um vom Iliosakralgelenk ausgehende Schmerzen zu diagnostizieren [29]. Eine kürzlich durchgeführte systematische Übersichtsarbeit und Meta-Analyse kam jedoch zu dem Schluss, dass sich diese Testreihe eher eignet, um eine Beteiligung des ISG auszuschließen, wenn sie negativ ist [30]. So verbleibt für die Therapeut*innen also ein Rest an Ungewissheit, aber es gibt noch weitere Faktoren, die sie bei ihrer Hypothesenbildung berücksichtigen können.…”