Comprehensive Osteopathic Medical Licensing Examination (COMLEX USA) Practice

In a Left on Left sacral torsion, what is the position of the ILA?

1. Deep

2. Anterior

3. Posterior

4. Shallow

The correct answer is: Posterior

In the case of a Left on Left sacral torsion, the position of the inferior lateral angle (ILA) is critical to understanding the mechanics involved. In this particular diagnosis, the sacrum is rotated such that the left side is posterior and inferior relative to the right side. This orientation results in the left ILA being positioned posteriorly in relation to the right ILA. As the sacrum rotates, the corresponding movement affects the ILA's palpatory position. Therefore, in a Left on Left sacral torsion, the left ILA will be more posterior compared to the right ILA, which is often understood as being deeper in relation to the left side due to the rotational dynamics of the torsion. Understanding this positional relationship helps clinicians in both diagnosis and treatment, as it directs attention to specific structural relationships and movement patterns affecting the pelvis and lower spine. Recognizing the posterior positioning of the left ILA in this scenario is essential for effective osteopathic manipulation and patient care.