Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with localized right-sided low back and buttock pain, exacerbated by prolonged sitting, standing, or transitional movements (sit-to-stand). Reports radiation to the right posterior thigh, stopping above the knee. Denies radicular symptoms, bowel/bladder dysfunction, or constitutional symptoms. Pain is described as [dull/aching/sharp], rated [X]/10.
Clinical Examination Findings
Physical examination reveals tenderness to palpation over the right sacroiliac joint (SIJ) and the right posterior superior iliac spine (PSIS). Provocative testing is positive on the right for: FABER test (Patrick’s), Gaenslen’s test, and Thigh Thrust. Right-sided SIJ compression and distraction maneuvers reproduce the patient’s concordant pain. No focal neurological deficits in the lower extremities; motor strength 5/5, sensation intact to light touch, DTRs 2+ and symmetric.
Treatment Protocol
Initiate conservative management including physical therapy focusing on pelvic stabilization and core strengthening. Prescribe NSAIDs for inflammation control. Activity modification to avoid aggravating positions. Consider SIJ corticosteroid injection under fluoroscopic guidance if symptoms persist beyond 6 weeks.