Sacral apex pressure test:

• This test is also known as the sacral thrust test
• Sacral compression test
• Downwards pressure test
• Sacral spring test
• Prone springing test

• This Sacral apex pressure test is a pain provocation test that is used to diagnose sacroiliac dysfunction.
• A positive test of single does not have high diagnostic accuracy but a combination with the other sacroiliac pain which is provocation tests gives valid evidence for the sacroiliac joint SI joint dysfunction.

What is the purpose of the Sacral apex pressure test?

• This Sacral apex pressure test is used to check the problem in the sacroiliac joint- SI joint.

How do you perform the Sacral apex pressure test?

• The patient lies in a prone position for the test.
• The patient lies in a prone position on a firm surface while the examiner places the base of his or her hand at the apex of the patient’s sacrum.
• Pressure is then applied to the apex of the sacrum on the ilium.

What is the result of the Sacral apex pressure test?

• The test may indicate a sacroiliac joint problem if the pain is produced over the joint.

• The test causes a rotational shift of the sacroiliac joints.

Evidence of the Sacral apex pressure test:

• The gold standard of the Sacral apex pressure test is to evaluate the sacroiliac pain provocation tests in the intra-articular injection of the local anesthetic in the SI joint = sacroiliac joint, under the guidance of radiological imaging.
• A specified level of pain reduction of 70-90% must be accomplished.

• There are some problems are available related to the use of this gold standard of this test:

• This test only investigated the intra-articular pain sources
• Not all structures but the capsule of the SI joint are affected
• The test must be used to a needle which is maybe produced & increase the pain
• Most pain provocation tests for the sacroiliac region exist & they have been subject to clinical research.
• Recommendation of Grade A which is based on the 3 levels of the 1B studies identifies the 4 to 5 tests with the highest specificity & sensitivity among known sacroiliac pain provocation tests & acceptable intertester reliability is also included in the clinical examination:

• Laslett et al
• Who is described to study in 2005
• In this state which is no further examination for wishful if both distraction & thigh thrust test provokes familiar pain.
• If only one test / other tests are positive further testing is required to obtain a valid result.
• Values for diagnostic utility are found here.

• The Sacral apex pressure test is to intertester reliability = 74 [moderate] kappa=0,52 & p<0,001.
• Sensitivity of the Sacral apex pressure test = 63%
• Specificity of the Sacral apex pressure test = 75%.
• The positive predictive value of the Sacral apex pressure test is= 56%
• The negative predictive value of the Sacral apex pressure test is = 80%.