Thigh Thrust Test
(Redirected from Posterior Shear Test)
Other Names
- PPPP Test
- P4 Test
- Thigh Thrust Test
- Posterior Shear Test
- POSH Test
- Femur Thigh Thrust Test
- Ostgaard Test
- 4P Test
- Posterior Pelvic Pain Provocation Test
Purpose
- Evaluate the Sacroiliac Joint
- Help distinguish between pain originating from the pelvic girdle and lower back
Description
- The patient is supine, hip and knee flexed to 90°
- One hand is placed beneath the sacrum in an attempt to stabilize its position
- The examiner then loads the femur axial pressure, applying a posterior force the the acetabulum and ilium
- Some have suggested to add hip adduction
- Positive test:
- Pelvic girdle pain is more likely if axial pressure provokes pain
- Sacroiliac pain is more likely to not be provoked by this maneuver
Pathology
- Sacroiliac Joint Pain
- Sacroilitis
- Pelvic Girlde Pain
Evidence
- Broadhurst et al: When FABER Test, Resisted Abduction Test and Posterior Shear Test used in combination[6]
- Sensitivity: 77-87%
- Specificity: 100%
- Freburger et al
- Sensitivity: 80 - 88%[7]
- Specificity: 100%
- PPV: 25% - 70%
- NPV: 88% - 92%
- Szadek et al[8]
- Sensitivity: 91%
- Specificity: 66%
- Diagnostic OR: 17.1
See Also
References
- ↑ von Heymann, Wolfgang, Horst Moll, and Geraldine Rauch. "Study on sacroiliac joint diagnostics." Manuelle Medizin 56 (2018): 239-248.
- ↑ Image courtesy of https://www.thestudentphysicaltherapist.com/, "POSH Test"
- ↑ Chen, Yung C., Michael Fredericson, and Matthew Smuck. "Sacroiliac joint pain syndrome in active patients: a look behind the pain." The Physician and sportsmedicine 30.11 (2002): 30-37.
- ↑ Buchanan, Patrick, et al. "Successful diagnosis of sacroiliac joint dysfunction." Journal of pain research (2021): 3135-3143.
- ↑ Líška, D., R. Zelník, and N. Hegedüšová. "Clinical examination of the sacroiliac joint." Journal of Orthopaedics, Trauma and Rehabilitation 28 (2021): 22104917211000755.
- ↑ Broadhurst NA, Bond MJ. Pain provocation tests for the assessment of sacroiliac joint dysfunction. J. Spinal Disord. 11(4), 341-345 (1998).
- ↑ JK Freburger, DL Riddle. Using published evidence to guide the examination of the sacroiliac joint region. Phys Ther. 2001; 81:1135–1143
- ↑ Szadek, Karolina M., et al. "Diagnostic validity of criteria for sacroiliac joint pain: a systematic review." The Journal of pain 10.4 (2009): 354-368.
Created by:
John Kiel on 7 August 2019 22:38:31
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Last edited:
1 June 2026 23:02:59
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