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Diagnosis of Sacroiliac Joint Dysfunction: Physical Exams, X-ray, CT and MRI scans

Published on 17th December 2018
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Diagnosis of Sacroiliac Joint Dysfunction: Physical Exams, X-ray, CT and MRI scans

The sacroiliac (SI) joint is deep in your back, where your pelvis is joined to the spine. While the sacroiliac can be a common cause of back pain, the fact that it’s under such a thick layer of skin and muscle makes it hard to diagnose when something goes wrong with it. And since there are so many possible causes of back pain, it’s important that your doctor be able to make an accurate diagnosis before recommending treatment. Here are some of the methods your doctor may use to test for sacroiliac joint dysfunction.

Sacroiliac Joint

The sacroiliac joint (or SI Joint) covers the sacrum with the pelvis and is adjacent to the bottom of the

Physical tests

There are various SI joint dysfunction special tests your doctor can use to determine how well your sacroiliac joint is moving. There are several different types of physical tests, but they all involve you lying down or balancing on one leg while your doctor gently manipulates your back, hips, or knees to find out which motions cause you pain. These tests can help evaluate your sacroiliac joint function and also discover other potential back and hip problems that might also be causing your pain. Another form of physical test is the finger test, in which your doctor will ask you to point to the spot on your back where the pain is most concentrated. He or she will be able to judge how close this spot is to the location of the SI joint, which helps give an indication of whether the joint is involved in your pain.

doctor physical test

Imaging exams

Your doctor may suggest imaging, such as an X-ray, MRI, or CT scan. This is usually only done when physical tests have suggested the possibility of SI joint dysfunction, to help your doctor develop a more accurate diagnosis. These can help show any abnormalities around your sacroiliac joint. They are also useful for detecting possible other problems with your spine and pelvis such as fractures or slipped discs. MRI images of SI joint dysfunction can help pinpoint the problem and allow your doctor to plan further treatment.

doctor physical test


The doctor uses a needle to inject a numbing medication directly into the sacroiliac joint. Since this joint is deep in the body, it requires a long needle, and the doctor will use an ultrasound or X-ray to help make sure it reaches the sacroiliac joint safely. If the injection significantly reduces or stops the pain, then it’s clear your sacroiliac is at fault. Like imaging, the injection test is usually only done for confirmation when the doctor already suspects sacroiliac dysfunction. You may feel some pain or bruising after the injection, and the doctor may give you a sedative to help make the process easier.

doctor physical test

Next Steps

If the doctor identifies the SI joint as the cause of your back pain, there are a variety of possible treatments, including medication, physical support such as braces, physical therapy, and, in the most serious cases, surgery. Your doctor will explain your options and work with you to find the best solution to your sacroiliac pain.

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