Thoracolumbar Complaint - Lab

Question 1

Piriformis Syndrome Presentation

Answer 1

1. Pain in buttock region, radiates to posterior thigh but usually stops above the knee
2. Worse with sitting, better with ambulation
3. Tenderpoint present at sciatic notch
4. May present with sciatica symptoms

Question 2

What is a Piriformis Syndrome Test

Answer 2

Positive Log Roll & FAIR test

Question 3

What is a positive Log Roll Test

Answer 3

Posterior Pain with sciatic notch tenderness

Question 4

A. What is the FAIR test

B. What is the setup

Answer 4

A. Specific test that determines sciatic notch irritation due to the piriformis.

B. Patient is laying lateral recumbent with affected hip up. Physician flexes, adducts and internally rotates top leg while stabilizing at the hip.

Question 5

What is a positive FAIR test

Answer 5

Pain at the sciatic/gluteal area

Question 6

Psoas Syndrome Presentation

Answer 6

1. Pain worsens with standing up straight
2. Patient may present with limbing or shuffling stride
3. Tenderpoint present medial to ASIS

Note: Iliopsoas is a hip flexor. A tight Iliopsoas would present with the hips being flexed. Possibly due to constantly sitting down.

Question 7

Specialty Test for Psoas Syndrome

Answer 7

Positive Thomas test and FABER test

Negative Log Roll test

Question 8

A. What does the Thomas test determine

B. What is a positive Thomas Test

Answer 8

A. Test for tight hip flexor muscle.

B. Inability to fully extend leg or leg raises off the table

Question 9

A. What is the FABER Test

B. What is the set up

C. What is a positive test

Answer 9

A. Test for Psoas Syndrome

B. Pt. supine, with hip flexed, abducted and externally rotated and ankle resting on contralateral leg

C. Groin pain

Question 10

If a FABER test presents with pain at the buttock region what does that mean?

Answer 10

Sacroiliac joint dysfunction = Hip pain

Question 11

Herniated Disc presentation

Answer 11

1. Leg pain
2. Numbness
3. TIngling
4. Loss of function in the impinged nerve root

Question 12

Herniated disc speciality test

Answer 12

Positive Straight Leg Raise between 30-60 degrees

Question 13

What does a Positive SLR at 15-30 degrees indicate

Answer 13

IT band contracture

Question 14

What does a positive SLR at 30-60 degrees indicate

Answer 14

1. Lumbar disc herniation at L4-S1 nerve roots
2. Lumbosacral radiculopathy (pain running down posterior leg)
3. Sciatic neuropathy

Question 15

What does a positive SLR grater than 70 degrees indicate

Answer 15

1. Mechanical low back pain
2. Pathology of hip or sacroiliaic joint
3. Hamstrings or glueteus maximus tightness

Question 16

Spondylolisthesis presentation

Answer 16

Pain worse with standing or walking but better with rest or spinal flexion. May cause muscle spasms of the hamstrings.

Question 17

Spondylolisthesis specialty test

Answer 17

Positive low midline sill (step-off) sign

Question 18

A. What is a Low Midline Sill (Step-off) Sign

B. What is the positive test

Answer 18

A. Tests for spondylolisthesis

B. Observable or palpable anterior displacement of superior segment compared to pathologica (affected) segment.

Question 19

A. What is Scoliosis

B. What is the specialty test for Scoliosis

Answer 19

A. Lateral curvature of the spine greater than 10 degrees with rotation. May be functional or structural. Names for side of convexity.

B. Positive Adam’s forward bend

Question 20

Functional vs. Structural Scoliosis

Answer 20

Function scoliosis is a resolution of the rib hump with sidebending. Structural scoliosis is a persistence of the rib hump with sidebending.