Lying prone or standing
If you wish to palpate on the skin, provide a private room for assessment. Ask the patient if he/she is willing to uncover the area ñ lowering pants and slightly lifting the bottom of the underwear. While the skin can not be viewed with clothes covering the area, the sacral angle usually can be palpated over clothing.
Posterior to the patient.
(Guide the patient to drape appropriately.) Please lie on your stomach. May I place my thumbs on the bottom of your hip bones? (and point to the area).
Guide the patient to drape appropriately. Hook your thumbs under the right and left sacral angles, which are bony ledges on the inferior sides of the sacrum.
VH - Skeleton of the trunk and pelvis and femur, posterior view
On one side, the erector spinae and hamstrings, gluteus maximus, quadratus femoris muscles and tendons