SI Joint Counternutation

Execution (for the right SIJ):

  1. The patient is in prone lying position with the examiner standing on the asymptomatic side
  2. The examiner puts the right hand on the posterior part of the patient’s right ilium and the left hand below sacral level S2 in quadrant 3 with the fingers pointing caudal to fixate the SIJ in counternutation direction
  3. The examiner then applies a force with both hands at the same time. The right hand will push into cranioventral and slight lateral direction, the left hand will push into ventrocaudal direction

 

Positive Outcome: The test is positive in case of pain provocation and/or changed end-feel (compared to the other side)

Study Reliability Sn Sp LR+ LR-
Robinson et al. (2007) Inter к= -0.04 NA NA NA NA
Comment: SIJ palpation tests for movement have shown to be unreliable without ‘pain provocation’ as an outcome measurement.