title: The diagnostic value of three sacroiliac joint pain provocation tests for sacroiliitis identified by magnetic resonance imaging.
abstract: OBJECTIVE
  The aim of the current study was to investigate the diagnostic value of three sacroiliac (SI) joint pain provocation tests for sacroiliitis identified by magnetic resonance imaging (MRI) and stratified by gender.
  
  
  METHODS
  Patients without clinical signs of nerve root compression were selected from a cohort of patients with persistent low back pain referred to an outpatient spine clinic. Data from Gaenslen's test, the thigh thrust test, and the long dorsal sacroilia ligament test and sacroiliitis identified by MRI were analysed.
  
  
  RESULTS
  The median age of the 454 included patients was 33 (range 18-40) years and 241 (53%) were women. The prevalence of SI joints with sacroiliitis was 5%. In the whole study group, only the thigh trust test was associated with sacroiliitis, the area under the receiver operating characteristic (ROC) curve (AUC) was 0.58 [95% confidence interval (CI) 0.51-0.65], sensitivity 31% (95% CI 18-47), and specificity 85% (95% CI 82-87). In men, sacroiliitis was associated with all the SI joint tests assessed and multi-test regimens, with the greatest AUC found for at least one positive out of three tests [AUC 0.68 (95% CI 0.56-0.80), sensitivity 56% (95% CI 31-79), and specificity 81% (95% CI 77-85)]. In women, no significant associations were observed between the SI joint tests and sacroiliitis.
  
  
  CONCLUSIONS
  Only in men were the SI joint tests found to be associated with sacroiliitis identified by MRI. Although, the diagnostic value was relatively low, the results indicate that the use of SI joint tests for sacroiliitis may be optimized by gender-separate analyses.
authors: a Research Department , Spine Centre of Southern Denmark, Hospital Lillebaelt , Middelfart , Denmark.|b Institute of Regional Health Research, University of Southern Denmark , Odense , Denmark.
authors: B
authors: B
authors: Arnbak
authors: a Research Department , Spine Centre of Southern Denmark, Hospital Lillebaelt , Middelfart , Denmark.|b Institute of Regional Health Research, University of Southern Denmark , Odense , Denmark.|c Department of Radiology , Aarhus University Hospital , Aarhus , Denmark.
authors: A G
authors: AG
authors: Jurik
authors: a Research Department , Spine Centre of Southern Denmark, Hospital Lillebaelt , Middelfart , Denmark.|b Institute of Regional Health Research, University of Southern Denmark , Odense , Denmark.
authors: R K
authors: RK
authors: Jensen
authors: a Research Department , Spine Centre of Southern Denmark, Hospital Lillebaelt , Middelfart , Denmark.|b Institute of Regional Health Research, University of Southern Denmark , Odense , Denmark.
authors: B
authors: B
authors: Schiøttz-Christensen
authors: d Research and Development, Military Rehabilitation Centre Aardenburg , Doorn , The Netherlands.|e Department of Physiotherapy , HU University of Applied Sciences , Utrecht , The Netherlands.
authors: P
authors: P
authors: van der Wurff
authors: a Research Department , Spine Centre of Southern Denmark, Hospital Lillebaelt , Middelfart , Denmark.|b Institute of Regional Health Research, University of Southern Denmark , Odense , Denmark.
authors: T S
authors: TS
authors: Jensen
mesh_terms: D000328:Adult; D019540:Area Under Curve; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging*; D058566:Sacroiliitis / Q000000981:diagnostic imaging*; D012727:Sex Characteristics