What should be included in evaluation of the SIJ?

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Evaluating the sacroiliac joint effectively requires a combination approach: provocative loading of the joint to reproduce pain, a validated criterion set to interpret those provocative tests, and screening for inflammatory or seronegative arthropathies that can mimic or accompany SI joint problems. Direct compression or distraction loads the SI joint itself and can reproduce pain if the joint is involved, helping to localize the source. Laslett’s criteria use a cluster of provocative maneuvers; when several of these tests are positive, the likelihood of SI joint pain being the culprit increases, providing a more reliable diagnostic signal than any single test alone. It’s also important to assess signs of seronegative arthritides because inflammatory conditions can involve the SI joints and influence treatment decisions, so recognizing these patterns ensures you don’t miss a systemic process. Because each component adds a different piece of information, including all of them gives the most accurate and comprehensive evaluation of the SI joint.