Emergency Medicine Bite-Sized Basics
- Position: standing in underwear
- Obvious other joint disease
- Deformity – scoliosis, loss of normal lumbar lordosis/thoracic kyphosis (ank. spondylosis)
- Each vertebrae, SIJs, and para-spinal muscle bulks
- Lumbar movements
- Forward flexion – touch toes.
- Schrober’s test: mark level of L5 (or dimples of Venus). Place one finger ~5 cm below this mark, and a second ~10 cm above this mark. When patient tries to touch toes distance should increase 5cm.
- Lateral flexion – slide hand down to touch knees
- Rotation (fix pelvis – e.g. by sitting)
- Straight leg raising (>60º)
- Test for radicular pain on dorsiflexing foot at limit of SLR
- Full neurological examination of lower limb
- Anal tone
- Test for saddle anaesthesia
- Ask about bladder & bowel problems