Thigh Thrust Test (Posterior Shear) Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Provocation test for Sacroiliac Joint (SIJ) dysfunction.
How to Perform
- Position: Patient lies supine. Examiner flexes the patient's hip to 90° with the knee bent.
- Action: Examiner applies a forceful vertical thrust down the femur (axial load) to shear the ilium posteriorly.
Interpretation of Results
- Positive Test: Reproduction of familiar pain in the SI joint.
Diagnostic Accuracy
- Sensitivity: 88% (High reliability when combined in a cluster).
Clinical Context & Limitations
The Thigh Thrust Test (Posterior Shear) should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Hip region, combining the Thigh Thrust Test (Posterior Shear) with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
