Manual Medicine Diagnostics

Region: Pelvic Girdle, Sacroiliac jOint (SIJ) Examination: Spine test, active motion testing for nutation movement Examination Procedure 90°. When there is an SIJ motion restriction (Figs. 5.72,5.73) the ilium does not descend and the above The patient is standing with his or her back to the described angle remains at 90° (Dejung, 1985). examiner. With both feet planted firmly on the ground, the patient is requested to extend both Possible Pathological Findings knees. Next, the patient is instructed to push one If motion in one SIJ is lost, the palpated PSIS on that knee as far forward as possible. While doing so, if same side moves superiorly due to pelvic tilting. there is no SIJ restriction, the ilium on the side where the knee is flexed drops down and simultaneously undergoes a distinct counternutation backwards. While the patient remains in the standing position, the examiner loca lizes the posterior superior iliac spine (PSIS) on one side with one thumb, and with the other thumb the opposite median iliac crest is palpated at the same level (Fig. 5.71). The patient is again requested to push one knee as far forward as possible. If the SIJ is not restricted, the PSIS descends a distance of approximately 0.5 cm to a maximum of 2.0 cm with this induced movement. The angle formed by the body's longitudinal axis and a line connecting the two thumbs increases beyond 5.71 5.72 5.73 109 Copyrighted Material