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By Prodyut Das

Sign of the Buttock

by Stanley
(Sydney)

The Sign of the Buttock is a collection of signs that indicate a serious pathological problem with severe pain in the gluteal region and occasionally the groin. Such pathological condition could be traumatic, including fracture of the pelvis or sacrum. Insidious onset could involve an abscess, osteomyelitis,septic bursitis, infectious sacroiliitis, rheumatic bursitis, gluteal tumor or hematoma in the pelvic region. A patient with positive sign of the buttock should be referred immediately to an physician.

The patient generally experience difficulty in walking, and complains of severe pain in the gluteal region. The pain can radiate to posterior thigh and occasionally to the foot.

The sign of buttock is conducted with the patient supine while the clinician performs a passive SLR. A positive sign is indicated by the following:

• Extremely limited and painful SLR


• Extremely limited passive hip flexion with the knee flexed, with an empty end feel


• A non capsular pattern of the passive hiphip test

To determine the cause of a positive sign of the buttock, a bone scan should be performed, along with lab tests and imaging. The treatment will depend on the cause.