Correlation of clinical examination characteristics with three sources of chronic low back pain

Young, Sharon B.; Aprill, Charles; Laslett, Mark

doi:10.1016/s1529-9430(03)00151-7

Cited by 237 publications

(190 citation statements)

References 26 publications

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“…Centralization of symptoms from repeated lumbar movements (McKenzie assessment) has high sensitivity and specificity for nerve root pain associated with symptomatic discs. 24 In the absence of centralization of posterior hip symptoms, 3 or more positive SIJ provocation tests have been shown to detect the presence of SIJ pathology and have a combined sensitivity of 91%, specificity of 78%, positive likelihood ratio of 4.12, and negative likelihood ratio of 0.12. 25,26 The suggested composite testing of the SIJ includes the thigh thrust, distraction, compression, sacral thrust, and Gaenslen tests.…”

Section: Femoroacetabular Joint Derangement (Ie Osteoarthritismentioning

confidence: 99%

Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin: A Narrative Literature Review of History, Physical Examination, and Diagnostic Imaging

Battaglia

D’Angelo

Kettner

2016

Journal of Chiropractic Medicine

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Objective: The purpose of this study was to present a narrative review of the literature of musculoskeletal causes of adult hip pain, with special attention to history, physical examination, and diagnostic imaging. Methods: A narrative review of the English medical literature was performed by using the search terms "hip pain" AND "anterior," "lateral," and "posterior." Additionally, specific entities of hip pain or pain referral sources to the hip were searched for. We used the PubMed search engine through January 15, 2016. Results: Musculoskeletal sources of adult hip pain can be divided into posterior, lateral, and anterior categories. For posterior hip pain, select considerations include lumbar spine and femoroacetabular joint referral, sacroiliac joint pathology, piriformis syndrome, and proximal hamstring tendinopathy. Gluteal tendinopathy and iliotibial band thickening are the most common causes of lateral hip pain. Anterior hip pain is further divided into causes that are intra-articular (ie, labral tear, osteoarthritis, osteonecrosis) and extra-articular (ie, snapping hip and inguinal disruption [athletic pubalgia]). Entrapment neuropathies and myofascial pain should also be considered in each compartment. A limited number of historical features and physical examination tests for evaluation of adult hip pain are supported by the literature and are discussed in this article. Depending on the clinical differential, the gamut of diagnostic imaging modalities recommended for accurate diagnosis include plain film radiography, computed tomography, magnetic resonance imaging, skeletal scintigraphy, and ultrasonography. Conclusions: The evaluation of adult hip pain is challenging. Clinicians should consider posterior, lateral, and anterior sources of pain while keeping in mind that these may overlap. (J Chiropr Med 2016;15:281-293)

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Section: Femoroacetabular Joint Derangement (Ie Osteoarthritismentioning

confidence: 99%

Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin: A Narrative Literature Review of History, Physical Examination, and Diagnostic Imaging

Battaglia

D’Angelo

Kettner

2016

Journal of Chiropractic Medicine

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“…Broadhurst and Bond [49] reported a sensitivity of 77-87 % for positive responses to three SIJ provocation tests. Thus, there is evidence of good diagnostic validity of positive responses to a threshold of three SIJ provocation tests to identify SIJ pain [49][50][51][52][53]. However, there are no studies that have specifically examined provocation tests in patients with SIJ pain after lumbar/lumbosacral fusion.…”

Section: Physical Examinationsmentioning

confidence: 99%

Sacroiliac joint pain after lumbar/lumbosacral fusion: current knowledge

Yoshihara

2012

Eur Spine J

110

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Recently, the sacroiliac joint (SIJ) has gained increased attention as a source of persistent or new pain after lumbar/lumbosacral fusion. The underlying pathophysiology of SIJ pain may be increased mechanical load, iliac crest bone grafting, or a misdiagnosis of SIJ syndrome. Imaging studies show more frequent degeneration of the SIJ in patients with lumbar/lumbosacral fusion than in patients without such fusion. Using injection tests, it has been shown that SIJ pain is the cause of persistent symptoms in a considerable number of patients after fusion surgery. Recent articles reporting on surgical outcomes of SIJ fusion include a high percentage of patients who had lumbar/lumbosacral fusion or surgery before, although well-controlled clinical studies are necessary to assess the efficacy of surgical treatment. Taking these findings into consideration, the possibility that the SIJ is the source of pain should be considered in patients with failed back surgery syndrome after lumbar/lumbosacral fusion.

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“…Patients who complain of pain when they arise after long term sitting present a classic sign of pain from the SIJs. 9 It is also common for patients to point directly over their left (L) and/or right (R) SIJs (posterior superior iliac spine (PSIS) region). This is referred to as Fortin's Finger Test.…”

Section: Subjective Datamentioning

confidence: 99%

“…10 A complaint of unilateral pain (on one side only) rather than bilateral pain is also considered more likely to be coming from an SIJ. 9 Another classic sign indicative of SIJ pain referral is the absence of lumbar pain above L5. 9 Pain perceived over one or both PSIS/SIJs and just lateral and/or inferior, in the buttock, is also a strong indicator of SIJP.…”

Section: Subjective Datamentioning

confidence: 99%