Spondylosis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; furthermore:
    • Inspection (viewing).
      • Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes.
      • Gait (fluid, limping).
      • Body or joint posture (upright, bent, relieved posture) [stiffness of the spine, restricted movement of the spine, forced posture].
      • Malpositions (deformities, contractures, shortenings).
      • Muscle atrophies (side comparison!, if necessary circumference measurements).
      • Joint (abrasions/wounds, swelling (tumor), redness (rubor), hyperthermia (calor); injury indications such as hematoma formation, arthritic joint lumpiness, leg axis assessment).
    • Palpation (palpation) of vertebral bodies, tendons, ligaments; musculature (tone, tenderness, contractures of paraverebral muscles); soft tissue swelling; tenderness (localization! ); limited mobility; “tapping signs” (test for painfulness of spinous processes, transverse processes, and costotransverse joints (vertebral-rib joints) and back muscles); illiosacral joints (sacroiliac joint) (pressure and tapping pain?; compression pain, anterior, lateral, or saggital); hyper- or hypomobility? [Spinal motion restriction?]
    • Functional testing
      • Finger-to-floor distance (FBA): assessment of the overall mobility of the spine, hips and pelvis. This is done by measuring the distance between the floor and the fingertips at maximum forward flexion, with the knees extended through. Normal finding: FBA 0-10 cm
      • Ott sign: Checking the mobility of the thoracic spine. For this purpose, a skin mark is applied to the standing patient over the spinous process of the seventh cervical vertebra (C7, HWK 7) and 30 cm further caudally (down). The changes in the measured distance during flexion (bending) are recorded. Normal findings: 3-4 cm.
      • Schober sign: Checking the mobility of the lumbar spine (LS). For this purpose, a skin mark is applied to the standing patient over the spinous process of S1 and 10 cm further cranially (above). At maximum flexion (after forward bending), the skin marks usually diverge by 5 cm, at retroflexion (after backward bending), the distance decreases by 1-2 cm.
    • If necessary, neurological examination [due topossible symptoms: paresthesias (insensitivity), sensory disturbances, paralysis].
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.