Derékfájás és alhasi fájdalom, Spondylolisthesis
Blue arrow normal pars interarticularis. A leaning-forward or semi- kyphotic posture may be seen, due to compensatory changes.
A "waddle" may be seen in more advanced causes, due to compensatory pelvic rotation due to decreased lumbar spine rotation. A result of the change in gait is often a noticeable atrophy in the gluteal muscles due to lack of use.
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Other symptoms may include tingling and numbness. Coughing and sneezing can intensify the pain. An individual may also note a "slipping sensation" when moving derékfájás és alhasi fájdalom an upright position. Sitting and trying to stand up may be painful and difficult.
The most common finding is pain with lumbar extension. However, a general examination, most importantly neurological examination, must be done to rule out alternative causes for signs and symptoms.
Neurological examination is often normal in patients with spondylolisthesis, but lumbosacral radiculopathy is commonly seen in patients with degenerate spondylolisthesis. Most patients present with a normal gait. An abnormal gait is often the sign of a high grade case.
Increased and decreased lumbar lordosis, inward curvature of the lower spine, has been seen. Spinous process palpation by itself is not a definitive method for the detection of spondylolisthesis.
Lumbar hyperextension — Extension often elicits pain. This can be assessed by having the patient hyperextend the lumbar spine, provide resistance against back extensions, or undergo repeated lumbar extensions.
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Sport-specific motion — Patient can be asked to repeat aggravating movements that they experience during their activity. During the movement, ask patient to point to any places with focal pain.
Straight leg raise — Maneuver used to assess for hamstring tightness. Weakness in these muscles can increase lordosis and contribute to sacroiliac instability.
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- Ízületek kezelése. térdfájdalom
The test involves the patient lying supine while holding a 45 degree flexed trunk and 90 degree flexed knees for 30 seconds. Gluteal strength can be assessed with a single leg squat. Lastly, lumbar extension can be assessed with a single leg bridge.
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Diagnostic Imaging[ edit ] In adults with non-specific low back pain, strong evidence suggests medical imaging should not be done within the first six weeks. Once imaging is deemed necessary, a combination of plain radiography, computed tomography, and magnetic resonance imaging may be used. Images are most often taken of the lumbar spine due to spondylolisthesis most commonly involving the lumbar region.
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Plain Radiography X-Ray [ edit ] Plain radiography is often the first step in medical imaging. Therefore, if further detail is needed a physician may request advanced imaging. Magnetic Resonance Imaging MRI [ edit ] Magnetic resonance imaging is the preferred advanced imaging technique for evaluation derékfájás és alhasi fájdalom spondylolisthesis.