Dreyfuss P, Michaelsen M, Pauza K, McLarty J, Bogduk N
Department of Rehabilitation Medicine, University of Texas Health Science Center, San Antonio, USA.
Spine (Phila Pa 1976). 1996 Nov 15;21(22):2594-602. doi: 10.1097/00007632-199611150-00009.
This prospective study evaluated the diagnostic utility of historically accepted sacroiliac joint tests. A multidisciplinary expert panel recommended 12 of the "best" sacroiliac joint tests to be evaluated against a criterion standard of unequivocal gain relief after an intra-articular injection of local anesthetic into the sacroiliac joint.
To identify a single sacroiliac joint test or ensemble of test that are sufficiently useful in diagnosing sacroiliac joint disorders to be clinically valuable.
No previous research has been done to evaluate any physical test of sacroiliac joint pain against an accepted criterion standard.
Historical data was obtained, and the 12 tests were performed by two examiners on 85 patients who subsequently underwent sacroiliac joint blocks. Ninety percent or more relief was considered a positive response, and less then 90% relief was considered a negative response.
There were 45 positive and 40 negative responses. No historical feature, none of the 12 sacroiliac joint tests, and no ensemble of these 12 tests demonstrated worthwhile diagnostic value.
Sacroiliac joint pain is resistant to identification by the historical and physical examination data from tests evaluated in this study.
这项前瞻性研究评估了历来公认的骶髂关节检查的诊断效用。一个多学科专家小组推荐了12项“最佳”骶髂关节检查，以关节内注射局部麻醉剂至骶髂关节后明确的疼痛缓解作为标准对照来进行评估。
确定一项单独的骶髂关节检查或一组检查，其在诊断骶髂关节疾病方面足够有用，具有临床价值。
以前没有针对公认的标准对照来评估任何骶髂关节疼痛体格检查的研究。
获取历史数据，两名检查者对85名随后接受骶髂关节阻滞的患者进行了这12项检查。疼痛缓解90%或更多被视为阳性反应，缓解少于90%被视为阴性反应。
有45例阳性反应和40例阴性反应。没有任何历史特征、这12项骶髂关节检查中的任何一项以及这12项检查的任何组合显示出有价值的诊断价值。
根据本研究评估的检查中的历史和体格检查数据，骶髂关节疼痛难以识别。
