UNILATERAL HIP ROTATION RANGE OF MOTION ASYMMETRY IN PATIENTS WITH SACROILIAC JOINT REGIONAL PAIN

Study Design. A cross-sectional study was used to determine whether li mited range of motion in the hip was present in 100 patients-one group with unspecified low back pain and another group with signs suggestin g sacroiliac joint dysfunction. Objectives. To determine whether a cha racteristic pattern of range of motion in the hip is related to low ba ck pain in patients and to determine whether such a pattern is associa ted with and without signs of sacroiliac joint dysfunction. Summary of Background Data. The sacroiliac joint is often considered a potential site of low back pain. Problems with the sacroiliac joint, as well as with the low back, have often been related to reduced or asymmetric r ange of motion in the hip. The correlation between sacroiliac joint dy sfunction and hip range of motion, however, has not been thoroughly ev aluated with reliable tests in a population of patients with low back pain. Methods. Passive hip internal and external rotation goniometric measurements were taken by a blinded examiner, while a separate examin er evaluated the patient for signs of sacroiliac joint dysfunction. Pa tients with sacroiliac joint dysfunction were further classified as ha ving a left or a right posteriorly tilted innominate. Results. The pat ients with low back pain but without evidence of sacroiliac joint dysf unction had significantly greater external hip rotation than internal rotation bilaterally, whereas those with evidence of sacroiliac joint dysfunction had significantly more external hip rotation than internal rotation unilaterally, specifically on the side of the posterior inno minate. Conclusions. Clinicians should consider evaluating for unilate ral asymmetry in range of motion in the hip in patients with low back pain. The presence of such asymmetry in patients with low back pain ma y help identify those with sacroiliac joint dysfunction.