{"id":10570,"date":"2026-08-24T00:20:52","date_gmt":"2026-08-24T08:20:52","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=10570"},"modified":"2026-07-02T16:43:17","modified_gmt":"2026-07-03T00:43:17","slug":"comlex-question-of-the-day-asis-compression-test","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/comlex-question-of-the-day-asis-compression-test","title":{"rendered":"COMLEX\u00ae Question of the Day:\u00a0ASIS compression test"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_86 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/comlex-question-of-the-day-asis-compression-test\/#The_correct_answer_to_todays_OMM%C2%AE_Question_is%E2%80%A6\" >The correct answer to today\u2019s OMM\u00ae Question is\u2026<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/comlex-question-of-the-day-asis-compression-test\/#Incorrect_Answer_Explanations\" >Incorrect Answer Explanations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/comlex-question-of-the-day-asis-compression-test\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/comlex-question-of-the-day-asis-compression-test\/#Major_Takeaway\" >Major Takeaway&nbsp;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/comlex-question-of-the-day-asis-compression-test\/#Want_to_learn_more_about_this_topic\" >Want to learn more about this topic?<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>Our latest OMM-style practice question to test your medical knowledge is here! Do you know the answer to this high-yield question on low back and anterior thigh pain? Let&#8217;s find out<\/em><\/strong>!<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 24-year-old woman presents to the clinic with two weeks of left-sided\u00a0<strong>low back pain<\/strong>\u00a0and\u00a0<strong>anterior thigh pain<\/strong>. She describes them both as dull with pain rated at 5\/10 on a 10-point scale. She has been training for a\u00a0<strong>marathon\u00a0<\/strong>for two months but has been unable to run recently due to pain. She has no weakness or decreased sensation in her lower extremities.\u00a0She has no significant medical history and takes no medications. Vital signs are within normal limits. On osteopathic structural examination, the\u00a0<strong>seated flexion test is negative bilaterally<\/strong>.\u00a0<strong>ASIS compression testing is positive on the left<\/strong>.\u00a0The\u00a0<strong>right ASIS is superior<\/strong>\u00a0relative to the left, and the\u00a0<strong>right PSIS is inferior<\/strong>\u00a0relative to the left.\u00a0<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Which of the following is the <em>most likely\u00a0<\/em>diagnosis?\u00a0<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Left-on-left sacral torsion<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Right-on-right sacral torsion<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Left innominate anterior rotation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Right innominate posterior rotation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Left innominate superior shear<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em>Scroll down for the correct answer!<\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_OMM%C2%AE_Question_is%E2%80%A6\"><\/span>The correct answer to today\u2019s OMM\u00ae Question is\u2026<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Left innominate anterior rotation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Correct:<\/strong> See Main Explanation.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_Answer_Explanations\"><\/span>Incorrect Answer Explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Left-on-left sacral torsion<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>\u00a0A sacral torsion would typically be associated with a positive seated flexion test. Additional findings may include a deep left sacral sulcus and inferior right ILA.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Right-on-right sacral torsion<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>\u00a0A sacral torsion would typically be associated with a positive seated flexion test. Additional findings may include a deep right sacral sulcus and inferior left ILA.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Right innominate posterior rotation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>\u00a0The ASIS compression test localizes the dysfunction to the left innominate. The left-sided landmarks (inferior ASIS and superior PSIS) indicate an anterior rotation, not a right posterior rotation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Left innominate superior shear<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>\u00a0A superior innominate shear causes all major pelvic landmarks on the affected side to move superiorly, including the ASIS, PSIS, and ischial tuberosity.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span>Main Explanation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The first step in diagnosing an&nbsp;<strong>innominate dysfunction<\/strong>&nbsp;is&nbsp;identifying&nbsp;the&nbsp;<strong>side of dysfunction<\/strong>, which can be&nbsp;accomplished&nbsp;using either the&nbsp;<strong>standing flexion test<\/strong>&nbsp;or the&nbsp;<strong>ASIS compression test<\/strong>. A positive ASIS compression test&nbsp;indicates&nbsp;restricted sacroiliac motion on that side. Once the dysfunctional side has been&nbsp;identified, the positions of the&nbsp;<strong>ASIS<\/strong>&nbsp;and&nbsp;<strong>PSIS<\/strong>&nbsp;are used to&nbsp;determine&nbsp;the specific diagnosis.&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Anterior innominate rotation<\/strong>:\u00a0inferior ASIS\u00a0and\u00a0superior PSIS\u00a0on\u00a0the affected side\u00a0<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Posterior innominate rotation<\/strong>:\u00a0superior ASIS\u00a0and\u00a0inferior PSIS\u00a0on the affected side\u00a0\u00a0<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Superior\u00a0innominate shear<\/strong>:\u00a0superior ASIS, superior PSIS, and superior ischial tuberosity on the affected side\u00a0<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Inferior innominate shear<\/strong>:\u00a0inferior ASIS, inferior PSIS, and inferior ischial tuberosity on the affected side\u00a0<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">In this patient, the&nbsp;<strong>ASIS compression test is positive on the left<\/strong>,&nbsp;identifying&nbsp;the&nbsp;left innominate&nbsp;as dysfunctional.&nbsp;The&nbsp;<strong>left ASIS is inferior<\/strong>&nbsp;relative to the right, and the&nbsp;<strong>left PSIS is superior<\/strong>&nbsp;relative to the right.&nbsp;Together, these findings&nbsp;establish&nbsp;the diagnosis of&nbsp;<strong>left innominate anterior rotation<\/strong>.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"975\" height=\"544\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/08\/image-4.png\" alt=\"Educational illustration showing how to assess pelvic bony landmarks from the anterior and posterior views. The anterior view highlights the anterior superior iliac spines (ASIS) and pubic rami, while the posterior view highlights the posterior superior iliac spines (PSIS) and ischial tuberosities. Hand placements demonstrate where these anatomical landmarks are palpated during a physical examination.\" class=\"wp-image-10573\" style=\"aspect-ratio:1.792276036720481;width:562px;height:auto\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/08\/image-4.png 975w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/08\/image-4.png?resize=300,167 300w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/08\/image-4.png?resize=768,429 768w\" sizes=\"auto, (max-width: 975px) 100vw, 975px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span>Major Takeaway&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">An&nbsp;<strong>anterior innominate rotation<\/strong>&nbsp;produces an&nbsp;<strong>inferior&nbsp;ASIS<\/strong>&nbsp;and&nbsp;<strong>superior PSIS<\/strong>&nbsp;on the dysfunctional side. Before interpreting pelvic landmarks, first&nbsp;identify&nbsp;the dysfunctional side using the&nbsp;<strong>standing flexion test<\/strong>&nbsp;or&nbsp;<strong>ASIS compression test<\/strong>.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>ASIS<\/strong>&nbsp;= anterior superior iliac spine;&nbsp;<strong>PSIS<\/strong>&nbsp;= posterior superior iliac spine;&nbsp;<strong>ILA<\/strong>&nbsp;= inferior lateral angle (of the sacrum)&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Want_to_learn_more_about_this_topic\"><\/span>Want to learn more about this topic?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Watch this Osmosis video: <\/strong><a href=\"https:\/\/www.osmosis.org\/learn\/Diagnosing_pelvis_somatic_dysfunction\">Diagnosing pelvis somatic dysfunction<\/a><\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><a href=\"https:\/\/www.osmosis.org\/plans\/do\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/hm-healthdigital-multisite.go-vip.net\/osmosisblog\/wp-content\/uploads\/sites\/2\/2025\/02\/health-sci-mo-ad.png\" alt=\"\" class=\"wp-image-5573\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/02\/health-sci-mo-ad.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/02\/health-sci-mo-ad.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Want more practice questions? Get your\u00a0<a href=\"https:\/\/www.osmosis.org\/plans\/do\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a>\u00a0and discover why millions of clinicians and caregivers love learning by Osmosis.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A marathon runner develops low back and anterior thigh pain with abnormal pelvic findings on structural examination. Can you identify the correct osteopathic diagnosis in this high-yield OMM-style case?<\/p>\n","protected":false},"author":208,"featured_media":10574,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[11,20,34,16,1366],"tags":[346,2967,3108,1076,3258,84,3206,645,462,2149,644,3259,3261,638,3260],"class_list":["post-10570","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-comlex","category-exam-prep","category-omm","category-do","category-questions","tag-anatomy","tag-board-exam-prep","tag-clinical-vignette","tag-comlex","tag-innominate-rotation","tag-medical-education","tag-musculoskeletal-medicine","tag-omm","tag-osmosis","tag-osteopathic-manipulative-medicine","tag-osteopathic-medicine","tag-pelvic-dysfunction","tag-sacroiliac-joint","tag-sports-medicine","tag-structural-diagnosis"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - 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