Ozgocmen S et al. – A multi-test regimen of three or five sacroiliac pain provocation tests may improve the accuracy of these tests discriminating sacroiliitis from low-back pain (LBP) of mechanical origin. Four out of five selected tests or any of the two out of three selected tests showed the highest predictive value. Methods
The aim of this study was to assess the value of pain provocation tests in detecting early active sacroiliitis
Chronic LBP pts were recruited and examined by blinded assessors for pain provocation tests
Pts underwent lumbar and sacroiliac MRI
Results
The percentage of agreement for each pain provocation tests was between 72–95%, and the inter-rater reliability was from moderate to good
Kappa values ranged from 0.43-0.60 with an agreement of 80–95% for clusters of pain provocation tests
As separately evaluated, pain provocation tests did not have favorable accuracy
When evaluated in clusters, 4 positive over 5 tests on the left side reached an area under the curve 0.693
2 positive over 3 tests reached an AUC 0.697
Sacroiliac pain provocation tests had acceptable reliability in early active sacroiliitis; however, the discriminating capacity of these tests was poor
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