Lumbar/pelvis Orthos Flashcards
Toe walking
S1 radiculopathy, L5-S1 disc problem, tibial nerve injury, weak calf muscles
Heel walking
L5 radiculopathy, L4-L5 disc problem, common peroneal nerve injury, weak anterior tibialis
Kemps Test
-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
Slump test
Px during any portion of the phase indicates meningeal tract irritation usually caused by a disc
Straight leg raise
(+)=local px with radiculopathy
0-35 SI lesion or piriformis
35-70 *sciatic nerve root irritation
70+ lumbar joint involvement
Bragards sign
(+) = dorsiflexion causes px
0-35 extradural sciatic nerve irritation
35-70 intradural problem such as IVD pathology
Well leg raise
Reproduction of px with radiculopathy on the affected side is indicative of a central or medial disc protrusion
Double leg raise
Pain reproduced when raising both legs in indicative of a central spinal canal disc defect
Goldthwaits Test
-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
Lewin Supine Test
Inability to sit up is associated with lumbar arthritis, lumbar fibrosis, lumbar disc protrusion, or sciatica
Linder’s Sign
-reproduction of discomfort indicates a disc lesion at the level of px
-sharp, diffuse px or involuntary hip flexion may indicate meningeal irritation
Pheasants Test
Spinal instability
Ely’s Test
-femoral radicular px indicates lumbar nerve root inflammation
-upper lumbar discomfort indicates nerve root adhesions
Bowstring
Pain in lumbar region or radiculopathy is a sign of sciatic nerve compression
Belt Test
Px with/without bracing=lumbar lesion
Px only without bracing=pelvic lesion
Bechterews Test
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
Lasegue
If there is px when the knee is extended the test is positive for sciatic radiculopathy
Bonnets test
Radicular px is indicative of sciatic nerve entrapment due to piriformis involvement
Nachlas test
-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
Erichsen’s sign
Test should reproduce px in sacroiliac is the source of px
Test will not reproduce px if iliofemoral joint is source of px
Iliac compression test
-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
Sacroiliac stretch test
unilateral SI or gluteal px signifies a positive test for anterior SI ligament sprain
Laguerre test
Positive test produces px within SI joint
-px felt within the iliofemoral joint indicates possible hip pathology
Gaenslen’s test
-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
