What exam suggests sacroiliitis?
Pelvic compression, Patrick’s test, and Gaenslen’s sign are exam maneuvers which may suggest sacroiliitis. Bilateral compression of the anterior iliac crests toward the midline on a supine patient may produce pathologic sacroiliac joint pain. Patrick’s test (also known as “figure of four test”) is performed in a supine position by having the patient f lex, ab duct, and e xternally r otate (FABER) the hip such that the ipsilateral heel rests on the contralateral knee. Downward gentle pressure is then increasingly applied on the ipsilateral knee while stabilizing the contralateral anterior iliac crest. Pain arising from the contralateral pelvis is suggestive of sacroiliitis. Gaenslen’s maneuver is performed with the patient supine and both hips and knees in flexion. The patient then moves one buttock off the examining table edge while extending the leg over the side. Sacroiliitis is suspected if the maneuver provokes sacroiliac discomfort on the side of the dropped leg.