Standing or standing with one foot supported on a chair or sidelying with the top hip flexed or lying prone.
If you wish to palpate on the skin, provide a private room and/or sheet or towel for cover. The patient is asked if he/she is willing to allow direct palpation on the skin, if needed, which might involve raising the bottom of the shorts or draping with a gown. While the skin can not be viewed with clothes covering the area, the two bony prominences needed to orient the ischial tuberosities and the greater trochanter usually can be palpated over clothing.
Posterior to the patient.
Damage to the sciatic nerve can be evaluated more accurately if you raise your shorts or wear a gown (and demonstrate the level, which is the level of the ischial tuberosities). Would you feel comfortable doing this? If not, I can assess some things without moving your clothing and with pressure from my fingers. Please stand (or other positions). May I place my fingers on the bone you sit on and another bone on the side of your thigh? (or demonstrate). (You can use a skeleton if available). Using those bones, I will press gently on the nerve that may be causing you trouble.
Guide the patient to drape and be in the position you want. If given permission, place your fingers on the patientÃs ischial tuberosity and greater trochanter, in the ways outlined for those palpations. The sciatic nerve travels between these two bony landmarks. Pressure on the sciatic nerve may cause tingling, pain, or other sensations along the distribution of the sciatic nerve.
This area of the body is very sensitive related to modesty. Allow adequate time for explanation and to request permission to touch and then to drape.
This area of the body is very sensitive related to modesty. Allow adequate time for explanation and to request permission to touch and then to drape.
VH - Posterior view of the ischial tuberosity to the greater trochanter with the sciatic nerve coursing in between