1b. OSCE Approach to Thoracolumbar Complaint

Question 1

Straight Leg Raise (Lasegue) Test

Answer 1

Question 2

Contralateral (Crossed) Straight Leg Raise Test

Answer 2

Question 3

Forward Bending Test (For Scoliosis)

Answer 3

Question 4

Increased thoracic kyphosis occurs with ___.

Answer 4

aging

Question 5

In ___, lateral and rotatory curvature of the spine brings the head back to midline.

Answer 5

scoliosis

Question 6

When do unequal shoulder heights occur?

Answer 6

• scoliosis
• Sprengel deformity of scapula from attachment of extra bone or band b/w upper scapula and C7
• “winging” of the scapul from loss of long thorcic nerve innervation to srratus anterior m. and contralateral weakness of the trapezius

Question 7

When do unequal heights of iliac crests or “pelvic tilt” occur?

Answer 7

• unequal leg lengths
  
  • check if unequal leg lengths disappear when block is placed under shorter limb
• scoliosis
• hip abduction or adduction
• “listing” of trunk to one side (seen w/ herniated lumbar disc)

Question 8

Deformity of thorax on forward bending, especially when height of scapula is unequal, suggests ____.

Answer 8

scoliosis

Question 9

Persistence of lumbar lordosis suggests ____ or ____.

Answer 9

• muscle spasms
• ankylosing spondylitis

Question 10

Decreased spinal mobility is common in ___ and ___.

Answer 10

• osteoarthritis (OA)
• ankylosing spondylitis

Question 11

Step-offs occur in ____, which may compress the spinal cord.

Answer 11

spondylolisthesis (foward slippage of 1 vertebra)

Question 12

Tenderness over the sacroiliac joint is common in ___ and ___.

Answer 12

• sacroiliitis
• ankylosing spondylitis

Question 13

When does pain with percussion of the spine occur?

Answer 13

• vertebral osteoporotic fracturs
• infection
• malignancy