Lab-Approach to Thoracolumbar Complaint

Question 1

what are the classic signs of piriformis syndrome?

Answer 1

pain in butt, radiates to posterior thigh (usually stops above knee), worse with sitting, better with ambulation

Question 2

what are the special tests associated with piriformis syndrome?

Answer 2

log roll and FAIR test

Question 3

What makes the log roll test positive?

Answer 3

posterior pain with sciatic notch tenderness

Question 4

What is involved in the FAIR test?

Answer 4

Flexion, adduction, and internal rotation

Question 5

what is the FAIR test used for?

Answer 5

it is a specific test for sciatic nerve irritation due to piriformis

Question 6

what makes the FAIR test positive?

Answer 6

if pain is produced in the sciatic/gluteal region

Question 7

what are the classic signs of psoas syndrome?

Answer 7

pain worse with standing straight up, patients limp or have shuffling stride, tenderpoint present medial to ASIS

Question 8

what are the specialty tests for psoas syndrome?

Answer 8

thomas test, FABER, and log roll

Question 9

how would you diagnose psoas syndrome?

Answer 9

if the thomas test and FABER was positive and if the log roll test was negative

Question 10

What is the set up of the thomas test?

Answer 10

patient lies supine with both legs hanging off of the end of the exam table; patient pulls knees to chest and extends one leg

Question 11

how do you get a positive thomas test?

Answer 11

if the patient has an inability to fully extend the leg or the leg raises off the table

Question 12

What is involved with the FABER test?

Answer 12

Flexion, abduction, and external rotation

Question 13

How do you get a positive FABER test?

Answer 13

if there is groin pain or if there is buttock pain

Question 14

what would a positive FABER test that causes groin pain indicate?

Answer 14

labral tears, Femoral acetabular impingement, osteoarthritis, iliopsoas bursitiis/strain

Question 15

what would a positive FABER test that causes buttock pain indicate?

Answer 15

sacroiliac joint dysfunction

Question 16

How does a herniated disc typically present?

Answer 16

leg pain, numbness, tingling, loss of function in the impinged nerve root

Question 17

what is the special test associated with a herniated disc?

Answer 17

straight leg raise

Question 18

how would you diagnose a herniated disc?

Answer 18

neurologic pain between 30-60 degrees

Question 19

When performing the straight leg raise, what would pain over the lateral leg at 15-30 degrees indicate?

Answer 19

IT band contracture

Question 20

when performing the straight leg raise, what would pain at anything greater than 70 degrees indicate?

Answer 20

mechanical low back pain due to muscle strain or joint disease, pathology of hip/ SI jointss, tightness of hamstrings or gluteus maximus

Question 21

What is the special test performed when checking for spndylolisthesis?

Answer 21

low midline sill (step-off) sign

Question 22

How would you know if a patient has functional scoliosis?

Answer 22

if there was resolution of the rib hump with sidebending

Question 23

How would you know if a patient has structural scoliosis?

Answer 23

if there was persistence of the rib hump with sidebending