Why yet another diagnostic sign of sacroiliac movement restriction?☆☆☆★

Background: Poor results of interexaminer and intraexaminer reliability of movement palpation tests for sacroiliac movement restriction are found in the literature. Objective: To analyze current diagnostic techniques for movement palpation. The most evident sources of error and technical pitfalls are detailed. Method: A random sample of 64 consecutive patients at a university hospital, inpatients and outpatients, were examined with the new technique, which was compared with a set of other techniques as detailed before and after treatment. Results: Full agreement was found in all but two cases in which head rotation was restricted and in two cases of severe scoliosis. The interexaminer reliability of the new test between two independent (blinded) examiners in 33 patients (66 joints) was in agreement in 82% and in disagreement in 18% (0.68 kappa). Conclusion: For its simplicity and lack of possible errors, this is a valuable sign. Its mechanism, however, is poorly understood. (J Manipulative Physiol Ther 1999;22:154–60)