Standing, sitting, or lying prone
If you wish to palpate on the skin, provide a private room for assessment. The patient is asked if he/she is willing to lower his/her pants a few inches. While the skin can not be viewed with clothes covering the area, the structure usually can be palpated over clothing.
Posterior to the patient.
The posture of your body can be evaluated more accurately if you lower your pants a few inches (and demonstrate the level). Would you feel comfortable doing this? (If standing), please take about 10 steps in place and then stand as you usually stand. (If sitting), sit as you usually do. May I touch the back of your hip bones? ( or point to the demonstrated area ). I may have to apply pressure.
Guide the patient to drape and then take steps in place if standing or sit in the usual posture if sitting. Slide each thumb from superior to inferior along the back of the pelvis until you sense dropping off a bony ledge. Bring your thumb up and under each ledge. You may need to apply pressure, so be sure the patient is stable and has something to lean forward on if needed.
If this palpation is used to assess lower limb length or pelvic symmetry/obliquity, compare height of thumb levels as the thumbs are held equally extended and parallel to the floor. Evaluate the PSIS levels at eye level.
If this palpation is used to assess lower limb length or pelvic symmetry/obliquity, compare height of thumb levels as the thumbs are held equally extended and parallel to the floor. Evaluate the PSIS levels at eye level.
VH - PSIS