Lumbar Spine

Question 1

What is Gluteal Tendinopathy?

Answer 1

A condition affecting the tendons of the gluteal muscles, often leading to hip and lateral pain.

Gluteal tendinopathy is characterized by pain and dysfunction in the hip region.

Question 2

What percentage of patients with extruded discs had full resorption according to Kesikburun 2019?

Answer 2

75%

This finding highlights the potential for recovery in patients with disc extrusion.

Question 3

What are Modic changes?

Answer 3

Changes in the vertebral endplates observed on MRI, classified into Type 1 (inflammatory), Type 2 (degenerative), and Type 3 (rare).

Modic changes can influence the diagnosis and treatment of back pain.

Question 4

What imaging technique is used to investigate neural encroachment?

Answer 4

Recumbent MRIs

Recumbent MRIs have a sensitivity of 25% for detecting disc bulges.

Question 5

What is the sensitivity and specificity of the Laslett cluster for SIJ pain diagnosis?

Answer 5

Sensitivity 91%, Specificity 87%

The Laslett cluster includes tests such as Distraction and Compression.

Question 6

What is the significance of centralization in diagnosing intervertebral disc issues?

Answer 6

Centralization often indicates discogenic pain, while its absence does not rule it out.

Patients are 5 times more likely to NOT have discogenic pain if no disc degeneration is observed on MRI.

Question 7

What is the most sensitive test for ruling out Deep Gluteal Syndrome?

Answer 7

Passive and active compression tests

These tests help differentiate between deep gluteal syndrome and other conditions.

Question 8

Fill in the blank: The best test to rule in Gluteal Tendinopathy is _______.

Answer 8

Resisted abduction

This test shows an 87-100% chance of having gluteal tendinopathy.

Question 9

What does a positive Extension-Rotation Test indicate?

Answer 9

Possible facet joint dysfunction

If painful with extension and rotation, it does not rule in facet dysfunction.

Question 10

True or False: Recumbent MRIs are appropriate standards for diagnosing pain.

Answer 10

False

They often produce false positives and false negatives.

Question 11

What is the highest positive likelihood ratio (PLR) for the relief with recumbency test?

Answer 11

1.1-2.7

This ratio indicates a significant association with facet joint issues.

Question 12

What imaging technique is best for diagnosing stress reactions?

Answer 12

MRI

Stress reactions are often better visualized on MRI than radiographs.

Question 13

What is the most specific test for ruling in SIJ pain?

Answer 13

ASIS Distraction Test

This test is crucial for confirming sacroiliac joint involvement.

Question 14

What does a positive Thigh Thrust/Posterior Pelvic Pain Provocation Test suggest?

Answer 14

Potential SIJ dysfunction

This test is sensitive for ruling out SIJ issues.

Question 15

What is the diagnostic significance of the FADIR test?

Answer 15

Helps identify labral tears and hip joint pathologies

FADIR test sensitivity ranges from 75-96%.

Question 16

What is the primary symptom of Deep Gluteal Syndrome?

Answer 16

Pain in the buttock region

Deep gluteal syndrome can mimic other conditions like sciatica.

Question 17

What is the prevalence of disc-related pain in patients aged 20-79% according to Hancock ‘07?

Answer 17

64%

This indicates a strong association between age and discogenic pain.

Question 18

What is the role of the sacral thrust test in diagnosing SIJ pain?

Answer 18

Part of the Laslett cluster, used to assess SIJ dysfunction

This test is one of several used to confirm SIJ involvement.

Question 19

What is the significance of the Gower’s sign in lumbar instability diagnosis?

Answer 19

Indicates potential instability or dysfunction in the lumbar region

Gower’s sign is assessed during a physical examination.