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Lumbar Spine Examination
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Standing
- Gait
- Stature
- Build
- Romberg
- Transitioning movements
- Posture and alignment
- Thoracolumbar alignment coronal and sagittal plane
- Lumbar alignment coronal and sagittal plane
- Pelvic alignment
- Foot alignment
- Movement
- Forward flexion
- Extension
- Side flexion
- Compound extension and rotation
- Trendelenburg
Sitting
- Breathing
- Pelvic alignment
- Slump test
Lying
- Skin drag and rolling
- Allodynia to cold and pin prick
- Palpation
- Vertebral springing tenderness
- Rotation testing
- Bony landmarks: Iliac crest, PSIS, LPSL, sacroiliac joint
- Soft tissue: sacrotuberous and sacrospinous ligaments, gluteus medius and gluteus minimus, piriformis, iliopsoas, quaratus lumborum, hamstring origin
- SIJ provocation testing: distraction, thigh thrust, sacral thrust, compression
- Hip joint range of motion
- Special tests
- Straight leg raise
- Femoral stretch test
- Iliopsoas length test and tenderness
- Direction preference
- Centralisation phenomenon
- Neurological examination
- Tone
- Power: hip flexion (L2), hip adduction (L3), ankle dorsiflexion (L4), great toe extension (L5), knee flexion (S1)
- Reflexes: knee (L3, L4), medial hamstring (L5), achilles (S1) [1]
- Sensation: L2, L3, L4 (medial lower leg 88%), L5 (first dorsal digit 82%), S1 (lateral 5th digit 88%), S2, S3 [2]
- Plantar reflexes