by Sillevis » Fri Sep 23, 2011 4:14 pm
Paula,
Looking at some of the test that have been used traditionally for patients suspected of SI dysfunction it seems that there is little current evidence supporting them. The Patrick test has a sensitivity and specificity ranging between 0.5-0.6. The positive likelihood for the Faber test is 1.4. This means that a positive Patrick test will not have any increase in probability that SI dysfunction is present. Additionally there is only fair inter-rater reliability using this test. Any assessment of palpation of bony landmarks either in standing or sitting is very unreliable. There have been some studies reporting slight agreement in inter-rater reliability, however not enough to hold on to this type of assessment. The leg length (supine to sit assessment) test sows poor inter-rater reliability and the positive likelihood ratio is only 1.22 making this not a test that increases the probability that you can identify a leg length difference in subjects. This leaves the question how do we assess it and how do we account for potential positive outcomes in our patients?