Diagnosing SI Joint Dysfunction

The most common symptom of SI joint dysfunction is pain, which is also a symptom of other conditions that can affect the lower part of the spine. This can make finding a definitive diagnosis difficult. Therefore, effective treatment requires the clinical knowledge, training and experience to recognize pain symptoms that may be caused by the SI joint, and then apply certain tests to arrive at a clear diagnosis.

Before performing specific diagnostic tests, your physician will discuss with you and review at length your medical history. Among the questions asked and factors discussed may be:

Identification of SI Joint Dysfunction Risk Factors

  • Any notable falls, missteps, awkward lifting or twisting of the pelvis over the course of your lifetime
  • Discussion of previous fusion surgery involving the lumbar spine (lower back)
  • Observation of uneven leg length, abnormal walking pattern or scoliosis
  • Past pregnancy (female patients)
  • Review of any previous diagnostic imaging (MRI, CT and X-rays)

After discussing your medical history with you, your physician will conduct a thorough physical examination. During this exam, if SI joint dysfunction is suspected, diagnostic tests may include:

Review of any previous diagnostic imaging (MRI, CT, X-rays)

  • X-ray and CT Scan – Useful in identifying a condition called sacroiliitis, this condition can appear on X-ray and CT as abnormal hardening of tissue (sclerosis) or severe wear (erosion) of the bone around the SI joints.
  • MRI –This imaging test can provide a more detailed view of the area surrounding the SI joint and is detailed enough to identify soft fractures not visible on X-ray, as well as inflammation of the SI joint by the observation of excessive fluid surrounding it.

Physical Examination
These are simple diagnostic aids that healthcare providers use to isolate the pain, determining whether it is (or isn’t) coming from the SI joint.

  • Fortin Finger Test1During this examination, you will stand and point to the area that hurts.
  • General Spine Exam –This exam is used to rule out red flags or other potential causes for your pain.
  • Provocative Tests –The purpose of these tests is to use pressure or movement to recreate the pain response in order to accurately identify its source.

SI Joint Injection
This is a crucial step in arriving at a definitive SI joint dysfunction diagnosis. If following the injection your pain is significantly decreased, then it is likely that the SI joint is a cause of, or major contributor to, the pain being experienced. But if the pain does not decrease following the injection, then the SI Joint is ruled out as the cause of the low back pain. Many physicians will repeat diagnostic injections in order to be completely sure of the diagnosis.

If you are experiencing low back pain and wondering if a problem with your SI joint is to blame, visit our Find a Doctor page to locate an expert healthcare professional in your area, trained in SI Joint Dysfunction diagnosis and treatment.

Diagnosing SI joint dysfunction

Ref 1. Fortin JD, F. F. (1997, July 26). The Fortin finger test: an indicator of sacroiliac pain. Retrieved February 2, 2015, from PubMed.gov