In the assessment of SI dysfunction, which test is performed first according to the clinical prediction rule?

• A. Compression test
• B. Sacral thrust
• C. Distraction test
• D. Thigh thrust test

Answer: (C)

In the assessment of sacroiliac (SI) dysfunction, the clinical prediction rule prioritizes the distraction test as the initial evaluation method. This test is designed to assess the integrity and functioning of the SI joint by applying a force that opens or distracts the joint. It provides valuable information regarding the patient's pain response and joint mobility, which can be critical in determining the presence of dysfunction.

Starting with the distraction test allows the clinician to gauge how the patient’s symptoms respond to an easy-to-perform and non-invasive maneuver. This initial evaluation can help differentiate between SI dysfunction and other potential sources of pain, such as lumbar spine issues. By identifying how the patient responds to this test, subsequent tests can be performed more effectively, ensuring a thorough and focused assessment based on the initial findings.

Ultimately, the distraction test serves as a foundation for the clinical prediction rule in assessing SI dysfunction, guiding the clinician through a systematic approach to diagnosis and treatment planning.