Diagnosis Using SI Joint Tests

A doctor will determine whether a person has sacroiliac joint disease by reviewing their medical history, taking x-rays, and reviewing the results of other tests that have been completed. Sometimes doctors make a definitive diagnosis through treatment. Doctors may also perform a series of provocative tests.

Is the SI joint the cause of my pain? - (01:21)

Dr. Carter Beck describes the process of ruling out other causes of the pain that may mimic the symptoms of SI joint disease. He says the main diagnostic tool for SI joint disease is an injection directly into the SI joint. Dr. Beck is a neurological surgeon at Montana Neurosurgical Specialists in Missoula, Montana.
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Confirming the SI joint as the source of pain - (02:37)

Dr. David Rouben describes diagnostic tests used to identify the sacroiliac joint as the source of pain. Dr. Rouben is an orthopaedic surgeon at Norton Spine Specialists in Louisville, Kentucky.
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Provocative tests are a non-invasive method for diagnosing pain from the sacroiliac (SI) joint. A clinician such as a physical therapist, pelvic health specialist, or pain management specialist can perform these tests to help a person diagnose SI joint disease or SI joint dysfunction.

During a provocative test, the clinician will perform a specific physical manoeuver while a person is lying in a particular position, in an attempt to recreate the pain. A positive result means the test recreated pain.

Positive results for at least three of the five provocative tests indicate that the SI joint is causing pain. The five provocative tests are called:

  • Distraction
  • Thigh Thrust
  • FABER (flexion, abduction, external rotation)
  • Compression
  • Gaenslen’s


With this test, a person lies on their back, with their lower back supported to help maintain the natural curve of the lower back (lumbar spine). The clinician places his or her hands on each side of the pelvis and applies a slow and steady pressure on each side of the pelvis.

Sacroiliac Joint Dysfunction Distraction Provocative Tes


During the Thigh Thrust provocative test, a person lies on their back with their hip flexed to 90 degrees and their knee bent. The clinician then applies a force through the femur.

Sacroiliac Joint Dysfunction Thigh Thrust Provocative Test


While a person is lying on their back, the clinician crosses their foot to the opposite side. The crossed foot is associated with the side of the body where a person feels symptoms of SI joint dysfunction. The clinician also places his or her hand on the pelvis of the opposite side of the body and applies pressure to the knee to exaggerate the motion of flexion, abduction, and external rotation.

Sacroiliac Joint Dysfunction Faber Provocative Test


With the compression test a person is lying on their side with their symptomatic side facing up. Their knees are bent, with support between the knees. The clinician applies pressure to the pelvis.

Sacroiliac Joint Dysfunction Compression Provocative Test


During this test a person lies on their back with their symptomatic side towards the side edge of the exam table and with their foot towards the floor. Shoulders should be towards the middle of the exam table for safety reasons. The clinician will ask to pull the non-symptomatic leg into the flexion position with the knee flexed. The clinician stabilises the legs with his or her hands.

Sacroiliac Joint Dysfunction Gaenslens Provocative Test