Fortin Finger Test

What is sacroiliac joint dysfunction?

Sacroiliac joint dysfunction is a condition that affects the sacroiliac (SI) joint, which connects the sacrum (the triangular bone at the bottom of the spine) to the pelvis. This joint can become a source of pain due to various factors, including injury, inflammation, or degeneration. Sacroiliac joint abnormalities can also contribute to pain in this area. Understanding the causes and symptoms is crucial for effective diagnosis and management.

Causes of sacroiliac joint dysfunction

Several factors can lead to sacroiliac joint dysfunction. Some of the most common causes include:

• Trauma or injury to the SI joint
• Arthritis or degeneration of the SI joint
• Pregnancy and childbirth, which can cause changes in the pelvis
• Inflammation due to conditions like ankylosing spondylitis
• Abnormal gait or movement patterns that stress the SI joint

Symptoms of sacroiliac joint dysfunction

Symptoms of sacroiliac joint dysfunction can vary but typically include:

• Pain localized to the lower back and buttocks
• Pain around the posterior superior iliac spine
• Pain that radiates to the upper thigh or groin
• Stiffness and reduced range of motion in the lower back
• Increased pain when standing up from a sitting position or prolonged standing
• Discomfort when climbing stairs or running

How to detect and diagnose sacroiliac joint pain

Detecting and diagnosing the sacroiliac joint pain and dysfunction involves a combination of clinical evaluation and diagnostic tests. Healthcare professionals start by taking the patient’s medical history, and a pain physician performs a physical examination, looking for tenderness over the SI joint and assessing the range of motion. Then, they use reliable diagnostic aids like the Fortin Finger Test, which is essential in this process.

Moreover, provocative tests such as the Flexion, Abduction, and External Rotation (FABER) Test and Gaenslen’s Test may be used to pinpoint the source of pain in the SI joint. These tests may be done to exclude other potential pain sources, such as posterior joint pain sources and zygapophyseal joint pain generators, during the evaluation. Additionally, imaging studies like X-rays, MRI, or CT scans can also be used to rule out other causes of lower back pain and provide detailed images of the SI joint.

In some cases, diagnostic injections of a local anesthetic into the painful region of the SI joint confirm the diagnosis if the patient’s lower back pain is temporarily relieved. Provocation-positive joint injections are also used to validate positive findings of sacroiliac joint abnormalities.

What is the Fortin Finger Test?

The Fortin Finger Test is a clinical assessment to detect sacroiliac joint dysfunction. It helps identify pain originating from the sacroiliac joint, often associated with lower back and lower limb pain. During the test, the patient is asked to use one finger to localize the area of pain. The examiner notes the location and allows the patient to relax. After five to ten minutes, the examiner asks the patient to identify the spot where they feel the most pain once more.

A positive test is indicated when the patient identifies the painful region as the area inferomedial to the posterior superior iliac spine (PSIS) within 1 cm on two separate occasions. This consistent localization of pain suggests sacroiliac joint dysfunction (Fortin & Falco, 1997).

How to use our Fortin Finger Test template?

The Fortin Finger Test template is designed to help healthcare professionals accurately assess sacroiliac joint dysfunction in patients. Follow these steps to utilize the template effectively:

Step 1: Download and prepare the template

Begin by downloading the Fortin Finger Test template from our website. Print out a copy for each patient you plan to assess. Familiarize yourself with the template's structure and sections to ensure a smooth testing process.

Step 2: Record patient information

Fill out the patient information section, including the patient’s name, date of birth, gender, test date, height, and weight. Accurate patient details are crucial for effectively tracking differential diagnoses and managing their condition.

Step 3: Explain the purpose and procedure

Clearly explain the purpose of the Fortin Finger Test to the patient. Inform them that the test helps detect sacroiliac joint dysfunction and guide them through the steps they will need to follow during the test. This preparation helps gain their cooperation and ensure accurate results.

Step 4: Conduct the test and record the findings

Use the instructions included in the template to conduct the test. Record their responses and any observations in the results section of the template afterwards.

Step 5: Interpret the results and plan the next steps

Interpret the results based on the patient's consistency and sensitivity in identifying the painful area. Use the indicators provided in the template to determine if the sacroiliac joint is the likely source pain. Document your findings and discuss the next steps with the patient, including further diagnostic tests or a treatment plan.

Benefits of using our template

Using our Fortin Finger Test template provides several advantages for healthcare professionals:

Standardized documentation

Our template consistently captures all necessary information, promoting accuracy and completeness in patient records. This standardization helps maintain high-quality documentation that can be quickly reviewed and referenced.

Time efficiency

Healthcare professionals can quickly and efficiently conduct and record the Fortin Finger Test for patients following a structured format. This efficiency allows more time to focus on patient care and other critical tasks.

Improved diagnostic accuracy

The template guides professionals through each step of differential diagnosis, ensuring no critical element is overlooked. This thoroughness improves the likelihood of accurately diagnosing sacroiliac joint dysfunction, leading to better patient outcomes.

Reference

Fortin, J. D., & Falco, F. J. (1997). The Fortin finger test: An indicator of sacroiliac pain. American Journal of Orthopedics (Belle Mead, N.J.), 26(7), 477–480. https://pubmed.ncbi.nlm.nih.gov/9247654/

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