Spine Orthopaedic Test: Seated Flexion Test

Seated Flexion Test is a physical examination test used to evaluate the presence of sacroiliac joint dysfunction or pain. The test assesses the movement and position of the posterior superior iliac spines (PSIS), which are bony prominences located at the back of the pelvis.

Procedure:

1. Position the patient in a seated position on a firm surface such as an examination table or chair.
2. Instruct the patient to place their hands on their knees and to bend forward as far as possible, keeping their knees straight.
3. Observe the patient's spine and back for any asymmetry or deviation from the midline, such as a lateral shift or rotation.
4. Palpate the patient's posterior superior iliac spines (PSIS) with both hands, noting any difference in height or position between the two PSIS.
5. Ask the patient to return to an upright seated position.
6. Repeat the forward flexion maneuver, this time instructing the patient to bend forward and reach towards the floor between their knees.
7. Again, observe the spine and back for any asymmetry or deviation from the midline, and palpate the PSIS for any difference in height or position.
8. Document any findings, such as a positive test result indicating sacroiliac joint dysfunction or pain.

A positive test result may indicate sacroiliac joint dysfunction or pain, which can be caused by a variety of factors such as trauma, arthritis, or pregnancy. A normal result of the Seated Flexion Test is the absence of asymmetry or deviation from the midline in the patient's spine and back during the forward flexion maneuver. This suggests that the sacroiliac joint is functioning normally and is stable.

References:

1. Dreyfuss P, Michaelsen M, Pauza K, McLarty J, Bogduk N. The value of medical history and physical examination in diagnosing sacroiliac joint pain. Spine (Phila Pa 1976). 1996;21(22):2594-2602.
2. Laslett M, Young SB, Aprill CN, McDonald B. Diagnosing painful sacroiliac joints: a validity study of a McKenzie evaluation and sacroiliac provocation tests. Aust J Physiother. 2003;49(2):89-97.
3. Broadhurst NA, Bond MJ. Pain provocation tests for the assessment of sacroiliac joint dysfunction. J Spinal Disord. 1998;11(4):341-345.
4. Laslett M, Oberg B, Aprill CN, McDonald B. Zygapophysial joint blocks in chronic low back pain: a test of Revel's model as a screening test. BMC Musculoskelet Disord. 2004;5(1):43.
5. Laslett M, et al. Systematic review of sacroiliac joint tests for diagnosing sacroiliac joint dysfunction. BMJ Open. 2016;6:e010368.