Case 1 | Examination

General Inspection

- Slim build

- Appears well

 

LOWER BACK:

Inspection:

- Lumbar spine looks very straight, with loss of the normal lumbar lordosis.

- Even for a slim gentleman his abdomen is very prominent.

- You notice there is also a forward sloping of the neck.

 

Palpation:

- No points of bony tenderness

- Some poorly localised tenderness on the sacroiliac joints bilaterally

- No paraspinal muscle tenderness

 

Movement:

Gait

- The patient walks with a stooped posture.

- He explains “I’ve found it difficult bending my neck back to look upwards on occasion”.

 

Screening for hip problems

- Full range of rotation, painless.

 

Neurological examination

- Motor – normal

- Sensory – normal

- Reflexes – normal

 

Nerve tension tests

- Straight leg raising – normal

- Laseuge’s test – normal

- Bowstring test – normal

- Femoral nerve stretch test - normal

 

Lumbar back movements

- Flexion (Schobers) - Less than 2 cm increase on maximal flexion

 

OTHER EXAMINATIONS:

- Chest Expansion - 0.5cm of chest expansion