If a negative seated flexion test is accompanied by shallow sacral bases and shallow ILAs, what is the most likely diagnosis?

• A. No dysfunction
• B. Bilateral extension
• C. Anterior torsion
• D. Posterior torsion

Answer: (A)

This item relies on how we interpret sacroiliac joint screening and sacral landmarks. A negative seated flexion test means there is no significant sacroiliac joint dysfunction on either side. When the sacrum is assessed further, bilateral shallow sacral bases and shallow inferior lateral angles indicate a neutral sacrum without rotation, flexion, or extension. In this neutral pattern, there isn’t the asymmetry or directional abnormality we’d expect with a torsion or a unilateral extension pattern. So the overall picture is that there is no sacral somatic dysfunction, i.e., no dysfunction.