Lab-Approach to Thoracolumbar Complaint Flashcards
what are the classic signs of piriformis syndrome?
pain in butt, radiates to posterior thigh (usually stops above knee), worse with sitting, better with ambulation
what are the special tests associated with piriformis syndrome?
log roll and FAIR test
What makes the log roll test positive?
posterior pain with sciatic notch tenderness
What is involved in the FAIR test?
Flexion, adduction, and internal rotation
what is the FAIR test used for?
it is a specific test for sciatic nerve irritation due to piriformis
what makes the FAIR test positive?
if pain is produced in the sciatic/gluteal region
what are the classic signs of psoas syndrome?
pain worse with standing straight up, patients limp or have shuffling stride, tenderpoint present medial to ASIS
what are the specialty tests for psoas syndrome?
thomas test, FABER, and log roll
how would you diagnose psoas syndrome?
if the thomas test and FABER was positive and if the log roll test was negative
What is the set up of the thomas test?
patient lies supine with both legs hanging off of the end of the exam table; patient pulls knees to chest and extends one leg
how do you get a positive thomas test?
if the patient has an inability to fully extend the leg or the leg raises off the table
What is involved with the FABER test?
Flexion, abduction, and external rotation
How do you get a positive FABER test?
if there is groin pain or if there is buttock pain
what would a positive FABER test that causes groin pain indicate?
labral tears, Femoral acetabular impingement, osteoarthritis, iliopsoas bursitiis/strain
what would a positive FABER test that causes buttock pain indicate?
sacroiliac joint dysfunction
How does a herniated disc typically present?
leg pain, numbness, tingling, loss of function in the impinged nerve root
what is the special test associated with a herniated disc?
straight leg raise
how would you diagnose a herniated disc?
neurologic pain between 30-60 degrees
When performing the straight leg raise, what would pain over the lateral leg at 15-30 degrees indicate?
IT band contracture
when performing the straight leg raise, what would pain at anything greater than 70 degrees indicate?
mechanical low back pain due to muscle strain or joint disease, pathology of hip/ SI jointss, tightness of hamstrings or gluteus maximus
What is the special test performed when checking for spndylolisthesis?
low midline sill (step-off) sign
How would you know if a patient has functional scoliosis?
if there was resolution of the rib hump with sidebending
How would you know if a patient has structural scoliosis?
if there was persistence of the rib hump with sidebending