Posterior Pelvic Pain Provocation Test

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Purpose
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The Posterior Shear Test (POSH Test) is a provocation test used to determine if a patient's pain is coming from the sacral iliac joint.  The actual name of this test as written in all of Laslett's work as the "Thigh Thrust Test".[1][2]

Technique
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With the patient supine, flex the patient's hip to 90 degrees.  Then the examiner applies an axial force posteriorly through the femur at varying angles of hip abduction and adduction.  The test is considered positive if it reproduces the patients buttock pain.

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Evidence[edit | edit source]

Laslet, et al, report the specificity as high as 100% ([1],[2]) and Broadhurst, et al, report the sensitivity as high as 80% ([4]), demonstrating good positive and negative predictive values.  The POSH test was only on of a few sacral-iliac joint tests that had both positive and negative predictive capabilities ([5]).

Resources[edit | edit source]

Wikipedia and AAOS

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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  1. ↑ 1.0 1.1 Laslett M, April CN, McDonald B, Young SB. Diagnosing Painful SI joints: A validation study of Mckenzie and SI provocation tests. Aust J Physiotherapy. 2003; 49:89-97.
  2. ↑ 2.0 2.1 Laslett M, Aprill CN, McDonald B, Young SB. Diagnosis of SI joint pain: validity of individual provocation test and composites of tests. Manual Therapy 2005; 10:207-218.
  3. ↑ Clinically Relevant Technologies http://www.youtube.com/watch?v=tabgNzqhTUQ; accessed May 2011
  4. ↑ Broadhurst NA, Bond MJ. Pain Provocation tests for the assessment of SI joint dysfunction. Jrnl of Spine Disorders 1998; 11(4):341-345.
  5. ↑ Mousaui SJ, Mousaui L, Alavizadeli A, Kamal S. Jrnl of Research in Rehabilitation Sciences; Vol 3, No.1(86).
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