Examination of the sacroiliac and lumbar spine may take various paths. The most tested of the above procedures is the Gillet motion palpation test, with preliminary indications that the intraexaminer reliability of the assessment may be acceptable.7,8 Radiographic findings are important for differentiating patients with lumbar and sacroiliac problems. The standing lateral radiograph is a useful way to assess the structural position of the lower spine and may quickly point to one area or the other as being potentially involved. A lumbar retrolisthesis indicates likely disc and posterior joint capsule injury,9 while a gross abnormality of the lumbar lordosis may imply a compensatory reaction from a lower level, such as the sacroiliac joint. A properly exposed well positioned standing lateral lumbar radiograph, and a Gillet motion palpation test of the sacroiliac articulations, in combination with a history of the timing and location of the pain, are valuable components for this type of evaluation.
Clinical guidelines are useful for patients and doctors concerned with standards of practice.
The protocol and indications for radiography however are quite different for medical versus chiropractic care. References Bigos SJ, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline. Junghanns H. Examination of the spinal column.