manuelletherapie 2009; 13(3): 124-134
DOI: 10.1055/s-0028-1109551
Originalarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Evidenzbasierte Diagnose und Behandlung bei schmerzhaftem Gelenk[1]

Evidence-Based Diagnosis and Treatment of the Painful Sacroiliac JointM. Laslett1
  • 1Auckland University of Technology, Director of Clinical Services and Clinical Expert, PhysioSouth Ltd., Christchurch, New Zealand
Further Information

Publication History

Manuskript eingetroffen: 6.8.2008

Manuskript akzeptiert: 20.8.2008

Publication Date:
15 July 2009 (online)

Zusammenfassung

SIG-Schmerzen haben ihren Ursprung in Gelenkstrukturen des SIG. Bei SIG-Dysfunktionen handelt es sich um eine anormale Position oder Bewegung von SIG-Strukturen, die Schmerzen auslösen können, aber nicht zwangsläufig müssen.

Diese Arbeit verdeutlicht die Unterschiede zwischen diesen klinischen Konzepten und informiert über die aktuelle Evidenz im Hinblick auf Diagnose und Behandlung von SIG-Störungen. Tests für SIG-Dysfunktionen zeichnen sich im Allgemeinen durch eine geringe Intertester-Reliabilität aus. Da noch kein Referenzstandard für SIG-Dysfunktionen zur Verfügung steht, lässt sich die Validität entsprechender Tests nicht bewerten. Tests, bei denen das SIG belastet wird, um die dem Patienten vertrauten Schmerzen auszulösen, haben eine akzeptable Intertester-Reliabilität und eine klinisch verwendbare Validität gegenüber einem akzeptablen Referenzstandard.

Es lässt sich nicht sagen, ob Provokationstests extraartikuläre SIG-Strukturen verlässlich identifizieren können. 3 oder mehr positive SIG-Schmerzprovokationstests besitzen eine Sensitivität und Spezifizität von 91 % bzw. 78 %. Die Spezifizität von 3 oder mehr positiven Tests erhöht sich auf 87 % der Patienten, deren Symptome nicht dazu gebracht werden können, sich auf die spinale Mittellinie zuzubewegen, d. h. zu zentralisieren.

Bei Populationen mit chronischen Rückenschmerzen besteht für Patienten mit 3 oder mehr positiven SIG-Provokationstests, deren Symptome nicht zur Zentralisierung veranlasst werden können, eine Wahrscheinlichkeit von 77 %, dass sie an SIG-Schmerzen leiden. Für schwangere Frauen mit Rückenschmerzen beträgt die Wahrscheinlichkeit 89 %. Diese Kombination von Testergebnissen könnte in der Forschung zur Evaluierung der Wirksamkeit bestimmter Behandlungsmethoden bei SIG-Schmerzen eingesetzt werden. Den größten Erfolg versprechende Behandlungen sind spezifisches Lenden-Becken-Stabilisationstraining und Kortikosteroid-Injektionen in den intraartikulären Raum.

Abstract

Sacroiliac joint (SIJ) pain refers to the pain arising from the SIJ joint structures. SIJ dysfunction generally refers to aberrant position or movement of SIJ structures that may or may not result in pain.

This paper aims to clarify the difference between these clinical concepts and present current available evidence regarding diagnosis and treatment of SIJ disorders. Tests for SIJ dysfunction generally have poor inter-examiner reliability. A reference standard for SIJ dysfunction is not readily available, so validity of the tests for this disorder is unknown. Tests that stress the SIJ in order to provoke familiar pain have acceptable inter-examiner reliability and have clinically useful validity against an acceptable reference standard. It is unknown if provocation tests can reliably identify extra-articular SIJ sources of pain. 3 or more positive pain provocation SIJ tests have sensitivity and specificity of 91 % and 78 %, respectively. Specificity of 3 or more positive tests increases to 87 % in patients whose symptoms cannot be made to move towards the spinal midline, i. e., centralise. In chronic back pain populations, patients who have 3 or more positive provocation SIJ tests and whose symptoms cannot be made to centralise have a probability of having SIJ pain of 77 %, and in pregnant populations with back pain, a probability of 89 %. This combination of test findings could be used in research to evaluate the efficacy of specific treatments for SIJ pain. Treatments most likely to be effective are specific lumbopelvic stabilisation training and injections of corticosteroid into the intra-articular space.

1 Der englische Originalartikel ist erschienen in: The Journal of Manual & Manipulative Therapy 2008; 16: 142 – 152.

Literatur

  • 1 Aina A, May S, Clare H. The centralization phenomenon of spinal symptoms: A systematic review.  Man Ther. 2004;  9 134-143
  • 2 Altman D G, Machin D, Bryant T N. et al . Statistics with Confidence. 2nd ed.  Oxford: Wiley-Blackwell. 2000; 
  • 3 Aprill C N. The Role of Anatomically Specific Injections into the Sacroiliac Joint. Vleeming A et al 1st Interdisciplinary World Congress on Low Back Pain and Its Relation to the S. I. Joint Rotterdam; ECO 1992: 373-380
  • 4 Berthelot J M, Labat J J, Le Goff B. et al . Provocative sacroiliac joint maneuvers and sacroiliac joint block are unreliable for diagnosing sacroiliac joint pain.  Joint Bone Spine. 2006;  73 17-23
  • 5 Bogduk N. The anatomical basis for spinal pain syndromes.  J Manipulative Physiol Ther. 1995;  18 603-605
  • 6 Bogduk N. Practice Guidelines: Spinal Diagnostic and Treatment Procedures. San Francisco; International Spine Intervention Society 2004
  • 7 Buchowski J M, Kebaish K M, Sinkov V. et al . Functional and radiographic outcome of sacroiliac arthrodesis for the disorders of the sacroiliac joint.  Spine J. 2005;  5 520-528
  • 8 Burnham R S, Yasui Y. An alternate method of radiofrequency neurotomy of the sacroiliac joint: A pilot study of the effect on pain, function, and satisfaction.  Reg Anesth Pain Med. 2007;  32 12-19
  • 9 Bussey M D, Yanai T, Milburn P. A non-invasive technique for assessing innominate bone motion.  Clin Biomech (Bristol, Avon). 2004;  19 85-90
  • 10 Carmichael J P. Inter- and intra-examiner reliability of palpation for sacroiliac joint dysfunction.  J Manipulative Physiol Ther. 1987;  10 164-171
  • 11 Childs J D, Fritz J M, Flynn T W. et al . A clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation: A validation study.  Ann Intern Med. 2004;  141 920-928
  • 12 Cibulka M T, Koldehoff R. Clinical usefulness of a cluster of sacroiliac joint tests in patients with and without low back pain.  J Orthop Sports Phys Ther. 1999;  29 83-99
  • 13 Clare H A, Adams R, Maher C G. Reliability of McKenzie classification of patients with cervical or lumbar pain.  J Manipulative Physiol Ther. 2005;  28 122-127
  • 14 Cohen S P, Abdi S. Lateral branch blocks as a treatment for sacroiliac joint pain: A pilot study.  Reg Anesth Pain Med. 2003;  28 113-119
  • 15 Dagenais S, Haldeman S, Wooley J R. Intraligamentous injection of sclerosing solutions (prolotherapy) for spinal pain: A critical review of the literature.  Spine J. 2005;  5 310-328
  • 16 Dar G, Peleg S, Masharawi Y. et al . The association of sacroiliac joint bridging with other enthesopathies in the human body.  Spine. 2007;  32 E303-E308
  • 17 Dar G, Khamis S, Peleg S. et al . Sacroiliac joint fusion and the implications for manual therapy diagnosis and treatment.  Man Ther. 2008;  13 155-158
  • 18 Van Deursen L LJM, Patijn J, Ockhuysen A L. et al . The value of some clinical tests of the sacroiliac joint.  J Manual Med. 1990;  5 96-99
  • 19 Donelson R, Silva G, Murphy K. Centralisation phenomenon: Its usefulness in evaluating and treating referred pain.  Spine. 1990;  15 211-213
  • 20 Donelson R, Grant W, Kamps C. et al . Pain response to sagittal end range spinal motion: A multi-centered, prospective, randomized trial.  Spine. 1991;  16 S206-S212
  • 21 Donelson R, Aprill C, Medcalf R. et al . A prospective study of centralization of lumbar and referred pain: A predictor of symptomatic discs and annular competence.  Spine. 1997;  22 1115-1122
  • 22 Donelson R. Rapidly Reversible Low Back Pain: An Evidence-Based Pathway to Widespread Recoveries and Savings. Hanover; Selfcare First LLC 2007
  • 23 DonTigny R L. Anterior dysfunction of the sacroiliac joint as a major factor in the etiology of idiopathic low back pain syndrome.  Phys Ther. 1990;  70 250-265; discussion 262 – 265
  • 24 DonTigny R L. A detailed and critical biomechanical analysis of the sacroiliac joints and relevant kinesiology. The implications for lumbopelvic function and dysfunction. Vleeming A, Mooney V, Stoeckart R Movement, Stability and Lumbopelvic Pain: Integration of Research and Therapy Philadelphia; Churchill Livingstone 2007 2nd ed
  • 25 Dreyfuss P, Dryer S, Griffin J. et al . Positive sacroiliac screening tests in asymptomatic adults.  Spine. 1994;  19 1138-1143
  • 26 Dreyfuss P, Michaelsen M, Pauza K. et al . The value of history and physical examination in diagnosing sacroiliac joint pain.  Spine. 1996;  21 2594-2602
  • 27 Dreyfuss P, Dreyer S J, Cole A. et al . Sacroiliac joint pain.  J Am Acad Orthop Surg. 2004;  12 255-265
  • 28 Elden H, Ladfors L, Olsen M F. et al . Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: Randomised single blind controlled trial.  BMJ. 2005;  330 761
  • 29 Ferrante F M, King L F, Roche E A. et al . Radiofrequency sacroiliac joint denervation for sacroiliac syndrome.  Regl Anesth Pain Med. 2001;  26 137-142
  • 30 Flynn T, Fritz J M, Whitman J. et al . A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with spinal manipulation.  Spine. 2003;  27 2835-2843
  • 31 Foley B S, Buschbacher R M. Sacroiliac joint pain: Anatomy, biomechanics, diagnosis, and treatment.  Am J Phys Med Rehabil. 2006;  85 997-1006
  • 32 Forst S L, Wheeler M T, Fortin J D. et al . The sacroiliac joint: Anatomy, physiology and clinical significance.  Pain Physician. 2006;  9 61-67
  • 33 Fortin J D, Dwyer A P, West S. et al . Sacroiliac joint: Pain referral maps upon applying a new injection/arthrography technique. Part I: Asymptomatic volunteers.  Spine. 1994;  19 1475-1482
  • 34 Fortin J D, Aprill C, Pontieux R T. et al . Sacroiliac joint: Pain referral maps upon applying a new injection/arthrography technique. Part II: Clinical evaluation.  Spine. 1994;  19 1483-1489
  • 35 Fortin J D, Washington W J, Falco F JE. Three pathways between the sacro-iliac joint and neural structures.  AJNR. 1999;  20 1429-1434
  • 36 Freburger J K, Riddle D L. Measurement of sacroiliac joint dysfunction: A multicenter intertester reliability study.  Phys Ther. 1999;  79 1134-1141
  • 37 Gemmell H A, Jacobson B H. Incidence of sacroiliac joint dysfunction and low back pain in fit college students (published erratum appears in J Manipulative Physiol Ther 1991; 14: 333 – 334)(see comments).  J Manipulative Physiol Ther. 1990;  13 63-67
  • 38 Greenman P E. Principles of Manual Medicine. Baltimore; Lippincott, Williams & Wilkins 1989
  • 39 Gunaydin I, Pereira P L, Fritz J. et al . Magnetic resonance imaging guided corticosteroid injection of sacroiliac joints in patients with spondylarthropathy. Are multiple injections more beneficial?.  Rheumatol Int. 2006;  26 396-400
  • 40 Gutke A, Ostgaard H C, Oberg B. Pelvic girdle pain and lumbar pain in pregnancy: A cohort study of the consequences in terms of health and functioning.  Spine. 2006;  31 E149-E155
  • 41 Haldeman S. Modern Developments in the Principle and Practice of Chiropractic. New York; Appleton 1980
  • 42 Hansen H C. Is fluoroscopy necessary for sacroiliac joint injections?.  Pain Physician. 2003;  6 155-158
  • 43 Hansen H C, Kenzie-Brown A M, Cohen S P. et al . Sacroiliac joint interventions: A systematic review.  Pain Physician. 2007;  10 165-184
  • 44 Haufe S M, Mork A R. Sacroiliac joint debridement: A novel technique for the treatment of sacroiliac joint pain.  Photomed Laser Surg. 2005;  23 596-598
  • 45 Herzog W, Read L J, Conway P J. et al . Reliability of motion palpation procedures to detect sacroiliac joint fixations.  J Manipulative Physiol Ther. 1989;  12 86-92
  • 46 Heuft-Dorenbosch L, Weijers R, Landewe R. et al . Magnetic resonance imaging changes of sacroiliac joints in patients with recent-onset inflammatory back pain: Inter-reader reliability and prevalence of abnormalities.  Arthritis Res Ther. 2006;  8 R11
  • 47 Horton S J, Franz A. Mechanical diagnosis and therapy approach to assessment and treatment of derangement of the sacro-iliac joint.  Man Ther. 2007;  12 126-132
  • 48 Hungerford B A, Gilleard W, Moran M. et al . Evaluation of the ability of physical therapists to palpate intrapelvic motion with the Stork test on the support side.  Phys Ther. 2007;  87 879-887
  • 49 Ikeda R. Innervation of the sacroiliac joint: Macroscopic and histological studies.  J Nippon Med School. 1991;  58 587-596
  • 50 Kilpikoski S, Airaksinen O, Kankaanpaa M. et al . Interexaminer reliability of low back pain assessment using the McKenzie method.  Spine. 2002;  27 E207-E214
  • 51 Knottnerus A. The Evidence Base of Clinical Diagnosis. London; BMJ Books 2002
  • 52 Kokmeyer D J, Wurff van der P, Aufdemkampe G. et al . The reliability of multi-test regimens with sacroiliac pain provocation tests.  J Manipulative Physiol Ther. 2002;  25 42-48
  • 53 Laslett M, Williams M. The reliability of selected pain provocation tests for sacro-iliac joint pathology.  Spine. 1994;  19 1243-1249
  • 54 Laslett M. Pain provocation sacroiliac joint tests: Reliability and prevalence. Vleeming A, Mooney V, Snijders CJ et al Movement, Stability and Low Back Pain: The Essential Role of the Pelvis New York; Churchill Livingstone 1997
  • 55 Laslett M, Young S B, Aprill C N. et al . Diagnosing painful sacroiliac joints: A validity study of a McKenzie evaluation and sacroiliac joint provocation tests.  Aust J Physiother. 2003;  49 89-97
  • 56 Laslett M, Aprill C N, McDonald B. et al . Diagnosis of sacroiliac joint pain: Validity of individual provocation tests and composites of tests.  Man Ther. 2005;  10 207-218
  • 57 Laslett M, McDonald B, Tropp H. et al . Agreement between diagnoses reached by clinical examination and available reference standards: A prospective study of 216 patients with lumbopelvic pain.  BMC Musculoskelet Disord. 2005;  6 28
  • 58 Laslett M, Oberg B, Aprill C N. et al . Centralization as a predictor of provocation discography results in chronic low back pain, and the influence of disability and distress on diagnostic power.  Spine J. 2005;  5 370-380
  • 59 Laslett M, Aprill C N, McDonald B. Provocation sacroiliac joint tests have validity in the diagnosis of sacroiliac joint pain.  Arch Phys Med Rehab. 2006;  87 874-875
  • 60 Laslett M, McDonald B, Aprill C N. et al . Clinical predictors of screening lumbar zygapophysial joint blocks: Development of clinical prediction rules.  Spine J. 2006;  6 370-379
  • 61 Laslett M, Oberg B, Aprill C N. et al . A study of clinical predictors of lumbar discogenic pain as determined by provocation discography.  Eur Spine J. 2006;  15 1473-1484
  • 62 Laslett M, Wurff van der P, Buijs E J. et al . Comments on Berthelot et al review „Provocative sacroiliac joint maneuvers and sacroiliac joint block are unreliable for diagnosing sacroiliac joint pain.  Joint Bone Spine. 2007;  74 306-307
  • 63 Lee D G. The Pelvic Girdle. Edinburgh; Elsevier 2004 3 rd ed
  • 64 Long A, Donelson R, Fung T. Does it matter which exercise? A randomized control trial of exercise for low back pain.  Spine. 2004;  29 2593-2602
  • 65 Maigne J Y, Aivaliklis A, Pfefer F. Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain.  Spine. 1996;  21 1889-1892
  • 66 Maugars Y, Mathis C, Berthelot J M. et al . Assessment of the efficacy of sacroiliac corticosteroid injections in spondylarthropathies: A double-blind study.  Br J Rheumatol. 1996;  35 767-770
  • 67 McCombe P F, Fairbank J CT, Cockersole B C. et al . Reproducibility of physical signs in low back pain.  Spine. 1989;  14 908-918
  • 68 McKenzie R A. The Lumbar Spine: Mechanical Diagnosis and Therapy. Waikanae; Spinal Publications 1981
  • 69 Meijne W, Neerbos van K, Aufdemkampe G. et al . Intraexaminer and interexaminer reliability of the Gillet test.  J Manipulative Physiol Ther. 1999;  22 4-9
  • 70 Mens J M, Snijders C J, Stam H J. Diagonal trunk muscle exercises in peripartum pelvic pain: A randomized clinical trial.  Phys Ther. 2000;  80 1164-1173
  • 71 Merskey H, Bogduk N. Classification of Chronic Pain: Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms. Seattle; IASP 1994 2nd ed
  • 72 Mior S A, McGregor M, Schut B. The role of experience in clinical accuracy.  J Manipulative Physiol Ther. 1990;  13 68-71
  • 73 Nilsson-Wikmar L, Holm K, Oijerstedt R. et al . Effect of three different physical therapy treatments on pain and activity in pregnant women with pelvic girdle pain: A randomized clinical trial with 3, 6, and 12 months follow-up postpartum.  Spine. 2005;  30 850-856
  • 74 O’Haire C, Gibbons P. Inter-examiner and intra-examiner agreement for assessing sacroiliac anatomical landmarks using palpation and observation: A pilot study.  Man Ther. 2000;  5 13-20
  • 75 Pereira P L, Gunaydin I, Trubenbach J. et al . Interventional MR imaging for injection of sacroiliac joints in patients with sacroiliitis.  Am J Roentgenol. 2000;  175 265-266
  • 76 Potter N A, Rothstein J M. Intertester reliability for selected clinical tests of the sacroiliac joint.  Phys Ther. 1985;  65 1671-1675
  • 77 Razmjou H, Kramer J F, Yamada R. Inter-tester reliability of the McKenzie evaluation in mechanical low back pain.  J Orthop Sports Phys Ther. 2000;  30 368-383
  • 78 Riddle D L, Freburger J K. Evaluation of the presence of sacroiliac joint region dysfunction using a combination of tests: A multicenter intertester reliability study.  Phys Ther. 2002;  82 772-781
  • 79 Robinson H S, Brox J I, Robinson R. et al . The reliability of selected motion and pain provocation tests for the sacroiliac joint.  Man Ther. 2007;  12 72-79
  • 80 Rosenberg J M, Quint T J, Rosayro A M. Computerized tomographic localization of clinically-guided sacroiliac joint injections.  Clin J Pain. 2000;  16 18-21
  • 81 Sackett D L, Haynes R B, Guyatt G H. et al .Clinical Epidemiology: A Basic Science for Clinical Medicine. Boston; Little, Brown and Company 1991 2nd ed
  • 82 Sackett D L, Straus S E, Richardson W S. et al .Evidence-Based Medicine: How to Practice and Teach EBM. Edinburgh; Churchill Livingstone 2000
  • 83 Schwarzer A C, Aprill de C, Bogduk N. The sacroiliac joint in chronic low back pain.  Spine. 1995;  20 31-37
  • 84 Schwarzer A C, Aprill C N, Derby R. et al . The false-positive rate of uncontrolled diagnostic blocks of the lumbar zygapophysial joints.  Pain. 1994;  58 195-200
  • 85 Schwarzer A C, Aprill C N, Derby R. et al . The relative contributions of the disc and zygapophyseal joint in chronic low back pain.  Spine. 1994;  19 801-806
  • 86 Slipman C W, Sterenfeld E B, Chou L H. et al . The value of radionuclide imaging in the diagnosis of sacroiliac joint syndrome.  Spine. 1996;  21 2251-2254
  • 87 Slipman C W, Sterenfeld E B, Chou L H. et al . The predictive value of provocative sacroiliac joint stress maneuvers in the diagnosis of sacroiliac joint syndrome.  Arch Phys Med Rehabil. 1998;  79 288-292
  • 88 Slipman C W, Lipetz J S, Plastaras C T. et al . Fluoroscopically guided therapeutic sacroiliac joint injections for sacroiliac joint syndrome.  Am J Phys Med Rehabil. 2001;  80 425-432
  • 89 Stoddard A. Manual of Osteopathic Technique. London; Hutchinson Medical Publishing 1969
  • 90 Stuge B, Laerum E, Kirkesola G. et al . The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: A randomized controlled trial.  Spine. 2004;  29 351-359
  • 91 Stuge B, Veierod M B, Laerum E. et al . The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: A two-year follow-up of a randomized clinical trial.  Spine. 2004;  29 E197-E203
  • 92 Sturesson B, Selvik G, Uden A. Movements of the sacroiliac joints: A roentgen stereophotogrammetric analysis.  Spine. 1989;  14 162-165
  • 93 Sturesson B. Load and movement of the sacroiliac joint (PhD thesis). Malmo; Lund University 1999
  • 94 Sturesson B, Uden A, Vleeming A. A radiostereometric analysis of the movements of the sacroiliac joints in the reciprocal straddle position.  Spine. 2000;  25 214-217
  • 95 Sturesson B, Uden A, Vleeming A. A radiostereometric analysis of movements of the sacroiliac joints during the standing hip flexion test.  Spine. 2000;  25 364-368
  • 96 Tong H C, Heyman O G, Lado D A. et al . Interexaminer reliability of three methods of combining test results to determine side of sacral restriction, sacral base position, and innominate bone position.  J Am Osteopath Assoc. 2006;  106 464-468
  • 97 Vallejo R, Benyamin R M, Kramer J. et al . Pulsed radiofrequency denervation for the treatment of sacroiliac joint syndrome.  Pain Med. 2006;  7 429-434
  • 98 Vincent-Smith B, Gibbons P. Inter-examiner and intra-examiner reliability of the standing flexion test.  Man Ther. 1999;  4 87-93
  • 99 Waddell G. The Back Pain Revolution. Edinburgh; Churchill Livingstone 1998
  • 100 Waldron T, Rogers J. An epidemiologic study of sacroiliac fusion in some human skeletal remains.  Am J Phys Anthropol. 1990;  83 123-127
  • 101 Ward S, Jenson M, Royal M A. et al . Fluoroscopy-guided sacroiliac joint injections with phenol ablation for persistent sacroiliitis: A case series.  Pain Pract. 2002;  2 332-335
  • 102 Werneke M, Hart D L, Cook D. A descriptive study of the centralization phenomenon: A prospective analysis.  Spine. 1999;  24 676-683
  • 103 Werneke M, Hart D L. Centralization phenomenon as a prognostic factor for chronic low back pain and disability.  Spine. 2001;  26 758-765
  • 104 Werneke M, Hart D L. Discriminant validity and relative precision for classifying patients with non-specific neck and low back pain by anatomic pain patterns.  Spine. 2003;  28 161-166
  • 105 Werneke M, Hart D L. Centralization: Association between repeated end-range pain responses and behavioral signs in patients with acute non-specific low back pain.  J Rehabil Med. 2005;  37 286-290
  • 106 Werneke M, May S. The centralization phenomenon and fear-avoidance beliefs as prognostic factors for acute low back pain.  J Orthop Sports Phys Ther. 2005;  35 844-845
  • 107 Wetzel F T, Donelson R. The role of repeated end-range/pain response assessment in the management of symptomatic lumbar discs.  Spine J. 2003;  3 146-154
  • 108 Van Wingerden J P, Vleeming A, Buyruk H M. et al . Stabilization of the sacroiliac joint in vivo: Verification of muscular contribution to force closure of the pelvis.  Eur Spine J. 2004;  13 199-205
  • 109 Van der Wurff P, Hagmeijer R H, Meyne W. Clinical tests of the sacroiliac joint: A systematic methodological review. Part 1: Reliability.  Man Ther. 2000;  5 30-36
  • 110 Van der Wurff P, Buijs E J, Groen G J. A multi-test regimen of pain provocation tests as an aid to reduce unnecessary minimally invasive sacroiliac joint procedures.  Arch Phys Med Rehabil. 2006;  87 10-14
  • 111 Yin W, Willard F, Carreiro J. et al . Sensory stimulation-guided sacroiliac joint radiofrequency neurotomy: Technique based on neuroanatomy of the dorsal sacral plexus.  Spine. 2003;  28 2419-2425
  • 112 Young S B, Aprill C N, Laslett M. Correlation of clinical examination characteristics with three sources of chronic low back pain.  Spine J. 2003;  3 460-465

1 Der englische Originalartikel ist erschienen in: The Journal of Manual & Manipulative Therapy 2008; 16: 142 – 152.

Mark Laslett

FNZCP, PhD, Dip Mt, Dip MDT, Senior Research Fellow Auckland University of Technology, Director of Clinical Services and Clinical Expert, PhysioSouth Ltd.

Christchurch

New Zealand

Email: mark.laslett@aut.ac.nz

    >