Lumbar/pelvis Orthos

Question 1

Toe walking

Answer 1

S1 radiculopathy, L5-S1 disc problem, tibial nerve injury, weak calf muscles

Question 2

Heel walking

Answer 2

L5 radiculopathy, L4-L5 disc problem, common peroneal nerve injury, weak anterior tibialis

Question 3

Kemps Test

Answer 3

-local lumbar px with radiation on the CONCAVITY indicates lateral disc lesion
-local lumbar px with radiation on the CONVEXITY indicates medial disc lesion
-local lumbar px with NO radiculopathy px indicates lumbar muscle spasm or facet capsulitis

Question 4

Slump test

Answer 4

Px during any portion of the phase indicates meningeal tract irritation usually caused by a disc

Question 5

Straight leg raise

Answer 5

(+)=local px with radiculopathy
0-35 SI lesion or piriformis
35-70 *sciatic nerve root irritation
70+ lumbar joint involvement

Question 6

Bragards sign

Answer 6

(+) = dorsiflexion causes px
0-35 extradural sciatic nerve irritation
35-70 intradural problem such as IVD pathology

Question 7

Well leg raise

Answer 7

Reproduction of px with radiculopathy on the affected side is indicative of a central or medial disc protrusion

Question 8

Double leg raise

Answer 8

Pain reproduced when raising both legs in indicative of a central spinal canal disc defect

Question 9

Goldthwaits Test

Answer 9

-px produced BEFORE the spinous fan (0-35) suspect SI lesion
-radicular px DURING lumbar fanning (35-70) suspect intradural lesion (disc, osteophyte, mass)
-local px AFTER lumbar fanning (70+) suspect posterior lumbar joint disorder

Question 10

Lewin Supine Test

Answer 10

Inability to sit up is associated with lumbar arthritis, lumbar fibrosis, lumbar disc protrusion, or sciatica

Question 11

Linder’s Sign

Answer 11

-reproduction of discomfort indicates a disc lesion at the level of px
-sharp, diffuse px or involuntary hip flexion may indicate meningeal irritation

Question 12

Pheasants Test

Answer 12

Spinal instability

Question 13

Ely’s Test

Answer 13

-femoral radicular px indicates lumbar nerve root inflammation
-upper lumbar discomfort indicates nerve root adhesions

Question 14

Bowstring

Answer 14

Pain in lumbar region or radiculopathy is a sign of sciatic nerve compression

Question 15

Belt Test

Answer 15

Px with/without bracing=lumbar lesion
Px only without bracing=pelvic lesion

Question 16

Bechterews Test

Answer 16

Radicular pain or if the patient must lean back due to pain indicates compression of sciatic nerve or lumbar nerve roots often due to lumbar disc protrusion

Question 17

Lasegue

Answer 17

If there is px when the knee is extended the test is positive for sciatic radiculopathy

Question 18

Bonnets test

Answer 18

Radicular px is indicative of sciatic nerve entrapment due to piriformis involvement

Question 19

Nachlas test

Answer 19

-radicular pain in anterior thigh may indicate L2-L4 compression or irritation by an intradural lesion, a lumbar plexus or femoral nerve compression from piriformis hypertrophy
-px in the buttock may indicate an SI lesion
-pc in lumbosacral joint may indicate a lumbosacral lesion

Question 20

Erichsen’s sign

Answer 20

Test should reproduce px in sacroiliac is the source of px
Test will not reproduce px if iliofemoral joint is source of px

Question 21

Iliac compression test

Answer 21

-px within either SI joint indicates sprain of posterior SI ligaments
-px on lateral surface of either ilia could indicate contusion or compression of soft tissue

Question 22

Sacroiliac stretch test

Answer 22

unilateral SI or gluteal px signifies a positive test for anterior SI ligament sprain

Question 23

Laguerre test

Answer 23

Positive test produces px within SI joint
-px felt within the iliofemoral joint indicates possible hip pathology

Question 24

Gaenslen’s test

Answer 24

-positive test reproduces px in SI region
-dull anterior thigh px indicates tight hip flexors
-radiation symptoms down the thigh suspect lumbar disc
-if test is negative, a lumbosacral lesion is suspected

Question 25

Milgrams TEst

Answer 25

Space occupying lesion inside or outside the spinal canal

Question 26

Lewin-Gaenslens Test

Answer 26

(+) = px in SI

Question 27

Hibbs Test

Answer 27

(+) = SI px
-px in iliofemoral joint indicates hip pathology

Question 28

Yeoman’s test

Answer 28

-px in SI joint indicates SI dysfunction
-dull, achy pain along anterior thigh indicates tight hip flexors