Sacroiliac dysfunction in construction workers.

BACKGROUND: In the literature of manual medicine the sacroiliac joint is widely accepted as a potential source of low back pain. On the other hand, some investigations have detected sacroiliac joint dysfunction without concomitant low back pain. The prevalence of sacroiliac dysfunction in the population has been noted in the medical literature to be between 19.3% and 47.9%. However, the prevalence of sacroiliac dysfunction in the general population and for construction workers is unknown. OBJECTIVE: This article presents results from the Hamburg Construction Workers Study in respect to sacroiliac diagnostics. The prevalence of and connection between sacroiliac dysfunction and low back pain are particularly interesting. DESIGN AND PARTICIPANTS: The sacroiliac joint diagnostics were studied in a cross-section investigation of a cohort of 480 male construction workers. Manual examination is the standard in the diagnostics of sacroiliac joint conditions at present. The assessment of sacroiliac joint function by standing flexion test, the spine test, the iliac compression test, and the iliac springing test was operationalized as two categories: sacroiliac dysfunction I and II. RESULTS: A prevalence of 29.0% was found for dysfunction I and 6.3% for dysfunction II, whereas a prevalence of 7.9% was found for the coprevalence of low back pain and sacroiliac dysfunction on the day of examination. This study demonstrated no statistical associations between low back pain and sacroiliac joint dysfunction. CONCLUSIONS: The reason why symptomatic and asymptomatic sacroiliac dysfunctions exist has not yet been sufficiently explained. The identification of pain-provoking factors should be the aim of subsequent investigations. A further study with a prospective design will be necessary to answer the questions that remain.

Sacroiliac joint diagnostics in the Hamburg Construction Workers Study.

BACKGROUND: In the medical literature, test procedures for sacroiliac joint diagnostics are viewed as controversial. The provocation tests are based on provoked sacroiliac pain, whereas the palpation tests examine the motion of the sacroiliac joint or describe the condition indirectly if limitation of the sacroiliac function is present. It must be presumed that the use of different test results in the detection of varying functional phenomena of a sacroiliac dysfunction or, alternatively, that identical effects of a dysfunction are evaluated in differing ways. OBJECTIVE: This article presents results with regard to the consistency of tests for sacroiliac joint dysfunctions carried out on participants from the building trade. DESIGN AND PARTICIPANTS: The consistency of the tests (standing flexion test, spine test, iliac compression test, iliac springing test) used in a cross-section investigation of a cohort of 480 male construction workers is presented. To evaluate the degree of consistency of the test procedure the percentage agreement and the kappa value, including a confidence interval of 95%, are given. RESULTS: The consistency between the iliac compression test and the three sacroiliac palpation tests could not be shown to be statistically significant. The consistency between the three palpation tests was moderate to good and the percentage agreement was acceptable (87.4%, 88.6%, 80.9%). CONCLUSIONS: It may be assumed that the palpation tests characterize the same dysfunction of the sacroiliac joint. Standing flexion test, spine test, and iliac springing test seem to be valuable tools for sacroiliac joint diagnostics.