Mekhail N, Saweris Y, Mehanny DS, et al. - In various studies, different contributions of clinical presentation, history, and physical examination in the diagnosis of SIJ pain have been described. This study was performed with the aim to determine the sensitivity and specificity of the diagnostic clinical tests and their predictive value in precisely diagnosing SIJ pain. Two hundred eligible patients with SIJ pain as their primary diagnosis were enrolled and re‐evaluated. These patients provided verbal rating scale (VRS) pain scores and demographic data and thereafter, underwent three SIJ diagnostic tests: the thigh thrust test, the Patrick test, and a modified version of the Gaenslen test that is referred to as the Mekhail test. Subsequently, the patients were administered SIJ injection, for which a confirmative result was ≥ 50% pain relief. In line with previous investigations, findings suggest a limited role of physical examination in diagnosing SIJ pain. Particularly, it was identified that no significant predictive capacity is added by clinical tests and/or their combinations when compared with patients’ baseline characteristics in predicting the response to diagnostic SIJ injection, albeit the combination of the Mekhail and Patrick tests yielded high sensitivity (94%), making them viable for consecutive screening, possibly lowering the unnecessary costs of diagnostic SIJ injection procedures.