Agreement and Sensitivity of Sacroiliac Joint Pain Provocation Tests

Kim, Min Seok; Kim, Hee Sang; Ahn, Kyung Hoi

Abstract

The purpose of this study is to assess agreement and sensitivity of sacroiliac joint pain provocation tests with fluoroscopically guided, diagnostic sacroiliac joint block. Thirty patients with sacroiliac joint area pain and without other obvious sources of pain were selected. The patients were tested with 11 kinds of sacroiliac pain provocation tests before and after sacroiliac joint block and their pain relief scales were measured before block, after 30 minutes, 1 week, and 2 weeks. According to pain relief scale at 30 minutes after sacroiliac joint block, the patients were divided into 3 groups - response group that was 100-70% pain relief; 9 cases(30%), partial response group that was 69-30% pain relief; 15 cases(50%), and nonresponse group that was 29-0% pain relief; 6 cases(20%). In the response and the partial response group, the sensitivity of pain provocation tests were 88.5% in FABERE, 53.9% in Erichen, 50.5% in Yeoman, 43.3% in Minor, and 38.5% in Gaenslen test. Gamma statistic for agreement in the 5 superior sensitive tests was 0.80 between Minor and Gaenslen test, 0.67 between Yeoman and Minor test, 0.48 between Yeoman and Gaenslen test, and 0.44 between FABERE and Minor test. Pain relief scale 2 weeks later were above 60% in response group and above 50% in partial and nonresponse group. In conclusion, combining the FABERE test and another sensitive test, we enhance diagnostic power for sacroiliac dysfunction.