Case 6 | Examination

General inspection

Normal build.

Restless in chair and stands up on a number of occasions with pain explaining that movement seems to help.

 

Observations

Pulse 89 reg.

BP 145/80.

Temp 37.1o

 

Back Inspection

Posterior – Nothing obvious.

Lateral – Loss of lumbar lordosis.

Gait – Unable due to the severity of the pain. 

 

Palpation

No Bony tenderness or SI joint tenderness.

No pain or swelling on palpation of paraspinal musculature.

 

Movement

Modified Schobers Test for flexion:  Limited to 3cm due to pain.

Extension:  Normal.

Lateral movements:  Normal.

 

 

Neurological examination

 

Motor power

Power (Lower Limb)

RIGHT

LEFT

Hip flexion

5

5

Knee flexion

5

5

Knee extension

5

5

Ankle dorsiflexion

5

5

Ankle plantarflexion

5

5

Great toe dorsiflexion

5

5

Great toe plantarflexion

5

5

 

 

Sensory

Normal.

Perianal sensation and tone not assessed.

 

Co-ordination

Normal.

 

Reflexes

Ankle – normal.

Knee – normal.

 

 

Nerve tension tests

Straight leg raising

Negative.

Lasegue’s test

Negative.

Bowstring test

Negative.

Femoral nerve stretch test

Not indicated.

 

 

Other Relevant Examinations

Screening for hip problems - Full range of rotation, painless.

Peripheral pulses  -  Intact.

 

Abdominal examination - Normal.  No AAA or palpable bladder.