What does a positive Goldthwait Test indicate if pain is reported prior to the LS junction moving?

• A. Contralateral SI sprain
• B. LS junction problem
• C. Ipilaterally SI sprain
• D. Femoral nerve injury

Answer: (C)

A positive Goldthwait Test indicates that if pain is reported prior to movement at the lumbar-sacral (LS) junction, it suggests a pathology related to the sacroiliac (SI) joint on the same side as the discomfort. In this test, the clinician lifts the leg while the patient is in a supine position, and pain occurring before the LS junction moves indicates that the source of the pain is at the sacroiliac joint.

When pain is experienced early in the test, it suggests that the dysfunction originates from the ipsilateral SI joint rather than from a lumbar spine issue or other structures. This understanding is crucial in differentiating between sacroiliac problems and lumbar spine conditions, making the identification of an ipsilateral SI sprain essential for guiding appropriate treatment strategies.

In contrast to other options, a contralateral SI sprain or a lumbar spine problem would typically present differently or lead to symptoms occurring after movement at the LS junction. A femoral nerve injury would present with different symptoms, often affecting the anterior thigh rather than presenting as SI pain. Thus, the accurate identification of the source of the pain as relating to the ipsilateral sacroiliac joint is pivotal in the clinical assessment.