Shimpi Prone SI Joint Test | SIJ Dysfunction Assessment

If you follow us for a while you know that SI joint dysfunction tests really don’t hold much value as they are unreliable and should be probably be abandoned. Despite findings that date back many years supporting these claims, Shimpi et al. (2018) have recently proposed a novel test for SI joint dysfunction.

The test’s sensitivity was rated at  82% and specificity at 77%. Among other reasons, the sample size was small at 45 participants, this being the first study to evaluate this test, and the current reference standard of fluoroscopically guided SI joint block was not used which is why the test has a weak clinical value.

To conduct the test, the patient is in prone lying position. You are going to stand or sit on the symptomatic side and place the palm of your hand under the patient’s anterior superior iliac spine. Then the patient is asked to extend the hip to around 15°, so the extended leg lifts slightly off the table.

The test is considered positive for SI joint dysfunction if the anterior superior iliac spine lifts off of the therapist’s palm and is accompanied by the reproduction of the patient’s familiar pain localized at the SI joint. In a negative test, the anterior superior iliac spine is supposed to press into the therapist’s hand and no pain is reproduced.

Other  orthopedic tests for SIJ dysfunction are:

• Standing Bent Over Test/Vorlauf Test
• Gillet / Marching / Sacral Fixation Test
• Sacroiliac joint Nutation
• Sacroiliac joint Counternutation

Due to the low reliability of SIJ dysfunction test, we advise leaving them behind and only focusing on SIJ provocation tests like the cluster of Laslett.

Shimpi, A., Hatekar, R., Shyam, A., & Sancheti, P. (2018). Reliability and validity of a new clinical test for assessment of the sacroiliac joint dysfunction. Hong Kong Physiotherapy Journal, 38(01), 13-22.