Case 1 | Examination
- Slim build
- Appears well
- 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.
- No points of bony tenderness
- Some poorly localised tenderness on the sacroiliac joints bilaterally
- No paraspinal muscle tenderness
- 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.
- 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
- Chest Expansion - 0.5cm of chest expansion