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Palpation; Ilium; Anatomic Landmarks; Motion; Physical Examination; Sacroiliac Joint
Objective: Previous research showed the Gillet sacroiliac joint (SIJ) motion test could not distinguish between actual SIJ movement and Trendelenburg-like pelvic obliquity. This study determined the feasibility of gathering data using a side-posture version of the Gillet test. The secondary goal was to determine if the results depended on whether the hip on the tested side was flexed actively or passively.
Methods: Subjects were placed in a baseline side-posture with the hip and knee of the lower leg flexed 450, with the upper leg straight. An examiner positioned his thumbs on the upside posterior superior iliac spine (PSIS) and S2 tubercle. The subject actively flexed the upper leg hip so it was superimposed over the lower leg, the examiner’s thumbs in place. After returning to the baseline position, a research assistant created passive flexion of the hip. Photographs were taken for the baseline, active hip flexion, and passive hip flexion positions. Photometric analysis measured PSIS/S2 displacements for all 3 test positions, left and right.
Results: A convenience sample of 34 asymptomatic subjects (68 SIJs) was recruited, 64.7% male. During active hip flexion the PSIS rose 2.22mm cephalad relative to S2; during passive hip flexion, it dropped 1.88mm. 29% of SIJs exhibited no movement. Wilcoxon testing confirmed statistical significance. Mean SIJ movement: 3.20mm caudal during passive hip flexion.
Conclusion: Although, it is feasible to perform Gillet testing in side posture, it is easier to perform with an assistant creating passive hip flexion.
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