Sacroiliac joint diagnostics in the Hamburg Construction Workers Study

BACKGROUND: In the medical literature, test procedures for sacroiliac joint diagnostics are viewed as controversial. The provocation tests are based on provoked sacroiliac pain, whereas the palpation tests examine the motion of the sacroiliac joint or describe the condition indirectly if limitation of the sacroiliac function is present. It must be presumed that the use of different test results in the detection of varying functional phenomena of a sacroiliac dysfunction or, alternatively, that identical effects of a dysfunction are evaluated in differing ways. OBJECTIVE: This article presents results with regard to the consistency of tests for sacroiliac joint dysfunctions carried out on participants from the building trade. DESIGN AND PARTICIPANTS: The consistency of the tests (standing flexion test, spine test, iliac compression test, iliac springing test) used in a cross-section investigation of a cohort of 480 male construction workers is presented. To evaluate the degree of consistency of the test procedure the percentage agreement and the kappa value, including a confidence interval of 95%, are given. RESULTS: The consistency between the iliac compression test and the three sacroiliac palpation tests could not be shown to be statistically significant. The consistency between the three palpation tests was moderate to good and the percentage agreement was acceptable (87.4%, 88.6%, 80.9%). CONCLUSIONS: It may be assumed that the palpation tests characterize the same dysfunction of the sacroiliac joint. Standing flexion test, spine test, and iliac springing test seem to be valuable tools for sacroiliac joint diagnostics.