Supine or sitting
If you wish to palpate on the skin, provide a private room or a sheet for cover. If you think this is necessary, ask the patient if he/she is willing to uncover the side of the abdomen and area of the iliac crest (or demonstrate). While the skin can not be viewed with clothes covering the area, the iliacus might be palpable over clothing.
Anterior to the patient for supine and posterior to the patient for sitting.
Please lie on your back (or sit leaning forward). May I touch the side of your abdomen and above your hip bone? (or point to the demonstrated area). Now slightly lift your knee.
Guide the patient to lie on his/her back (or sit) with the hips and knees flexed and feet supported. With the patient relaxed and with permission, place your fingers near the edge of the iliac crest. As the patient exhales, gently curve your fingers around the anterior portion of the iliac crest and onto the iliacus. Ask the patient to ever so slightly lift the knee to activate the iliacus and without activating the rectus abdominis.
If the patient sits, stand posteriorly to the patient and reach around the trunk for the same finger placement and procedure.
If the patient sits, stand posteriorly to the patient and reach around the trunk for the same finger placement and procedure.
VH - Iliacus