Yeoman’s test is a physical exam performed to determine if a person has sacroiliitis. With the subject prone, the test is performed by rotating the ilium with one hand and extending the hip while the knee is flexed. Pain over the ipsilateral posterior sacroiliac joint area is indicative of sacroiliitis.

This also tests for sacroiliac joint sprain or strain.

Purpose

Tests for Sacroiliac Joint involvement. More specifically, if the pain is in the sacroiliac region it may be related to anterior sacroiliac ligament pathology. If it is in the thigh it may be related to hip musculature tightness or femoral nerve tension and if it is in the lumbar region it may be due to lumbar involvement[rx]

Use: To assess for lumbar joint dysfunction.

Technique

Starting Position

The patient lies prone

Procedure

The examiner stands at the painful side and flexes the patient’s knee to 90° and extends the hip

To perform the test, the patient lies on their stomach.  The examiner uses one hand to stabilize the pelvis while the other hand lifts the leg off the table.  If the patient has pain over the buttock, it may suggest SI joint pain.  If the pain is in the front of the thigh, it may suggest nerve pain from stretching the femoral nerve.  Back pain may indicated pain coming from the lumbar spine.

Positive Test

Pain localized to the sacroiliac joint indicates pathology in the anterior sacroiliac ligament

Anterior thigh paresthesia may indicate a femoral nerve stretch[rx][rx]

Evidence

The thigh thrust test is most sensitive and the distraction test is the most specific. Only the thigh thrust test reaches more than 80% sensitivity and specificity. In the absence of centralization, if three provocative tests are positive then the sensitivity, specificity, and positive likelihood ratio are 93%, 89%, and 6.97%, respectively. Hence practically it is sufficient to do the thigh thrust test, sacroiliac distraction test, and the FABER test to arrive at a diagnosis.[rx][rx]

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References