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In the examination of a large number of patients with symptoms referable to sacro-iliac disease, bimanual examination of these joints has proved of clinical value. Their situation permits them to be examined quite easily by the following routine:
With the patient in a standing posture, the spine is flexed to a right angle, the arms being rested on a suitable support. The index finger of the right hand of the examiner is then introduced into the rectum and the outspread left hand is placed over the sacrum. With this technic, the lower portion of either sacro-iliac joint can be readily palpated, and in some instances the entire anterior portion of the joint can be examined. For the sake of thoroughness, it is best to examine the normal side first and compare it with the affected side. If there is any subluxation of the joint, as indicated
Gratz CM. BIMANUAL EXAMINATION OF THE SACRO-ILIAC JOINTS: ITS IMPORTANCE IN THE EARLY DIFFERENTIAL DIAGNOSIS OF SACRO-ILIAC DISEASE. JAMA. 1928;91(6):397. doi:10.1001/jama.1928.92700060004010e