title: Can hip abduction and external rotation discriminate sacroiliac joint pain?
abstract: OBJECTIVE
  The primary aim of the study is to determine if Hip Abduction and External Rotation (HABER) test is capable of reproducing familiar pain in individuals with low back pain (LBP) of sacroiliac joint (SIJ) origin (SIJ-positive) when compared with LBP of Non-SIJ origin (SIJ-negative). If so, the secondary aim is to determine the diagnostic accuracy of HABER test against the reference standard of pain provocation tests, and to determine which increments of the HABER test has highest sensitivity and specificity for identifying SIJ-positive individuals.
  
  
  METHODS
  Single-blinded diagnostic accuracy study.
  
  
  METHODS
  Participants [n(122)] between ages of 18-50 y, suffering from chronic non-specific LBP (≥3 months) volunteered in the study. An experienced musculoskeletal physiotherapist evaluated and classified participants into either SIJ-positive [n(45)] or SIJ-negative [n(77)], based on reference standard of pain provocation tests [≥3 positive tests = SIJ-positive]. Another musculoskeletal physiotherapist, blinded to clinical groups, evaluated participants for reproduction of familiar pain during each increment (10°, 20°, 30°, 40°, and 50°) of HABER test.
  
  
  RESULTS
  The HABER test reproduced familiar pain in SIJ-positive individuals when compared with SIJ-negative individuals [p (0.001), R(2) (0.38), Exp(β) (5.95-10.32)], and demonstrated moderate level of sensitivity (67%-78%) and specificity (71%-72%) for identifying SIJ-positive individuals. Receiver operator curve analysis demonstrated that the HABER increments of ≥30° have the highest sensitivity (83%-100%) and specificity (52%-64%).
  
  
  CONCLUSIONS
  The HABER test is capable of reproducing familiar pain in SIJ-positive LBP individuals and has moderate levels of sensitivity and specificity for identifying SIJ-positive LBP individuals.
authors: School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand; School of Physiotherapy, University of Otago, Dunedin, New Zealand. Electronic address: divya.adhia@otago.ac.nz.
authors: Divya Bharatkumar
authors: DB
authors: Adhia
authors: School of Physiotherapy, University of Otago, Dunedin, New Zealand.
authors: Steve
authors: S
authors: Tumilty
authors: School of Physiotherapy, University of Otago, Dunedin, New Zealand.
authors: Ramakrishnan
authors: R
authors: Mani
authors: School of Physiotherapy, University of Otago, Dunedin, New Zealand.
authors: Stephan
authors: S
authors: Milosavljevic
authors: School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand. Electronic address: melanie.bussey@otago.ac.nz.
authors: Melanie D
authors: MD
authors: Bussey
mesh_terms: D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D009520:New Zealand; D010147:Pain Measurement; D017699:Pelvic Pain / Q000175:diagnosis* / Q000628:therapy*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D012399:Rotation; D012446:Sacroiliac Joint / Q000503:physiopathology*; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D055815:Young Adult
keywords: Clinical tests; Sacroiliac joint; Sensitivity; Specificity