Physical Exam

Spine Inspection

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Video coming September 2026

How to Perform

With the patient standing and the back adequately exposed, inspect the spine from behind and from the side. Note the alignment of the spinous processes; the symmetry of the shoulders, scapulae, and iliac crests; and the cervical and lumbar lordosis and thoracic kyphosis. Look for any abnormal curvature, asymmetry, deformity, or skin changes.

How to Interpret

Vertebral Compression Fracture

Increased thoracic kyphosis with the back of the head held off the wall (wall-occiput distance greater than 0 cm)

Rule in

Somewhat helpful

Rule out

Somewhat helpful

Evidence:Limited

References

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Dunn J, Henrikson NB, Morrison CC, Blasi PR, Nguyen M, Lin JS. Screening for adolescent idiopathic scoliosis: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2018;319(2):173-187. PMID 29318283. doi:10.1001/jama.2017.11669.
Castro MP, Stebbings SM, Milosavljevic S, Bussey MD. Construct validity of clinical spinal mobility tests in ankylosing spondylitis: a systematic review and meta-analysis. Clin Rheumatol. 2016;35(7):1777-1787. doi:10.1007/s10067-015-3056-1. PMID: 26337175.
van der Windt DAWM, Simons E, Riphagen II, Ammendolia C, Verhagen AP, Laslett M, Devillé W, Deyo RA, Bouter LM, de Vet HCW, Aertgeerts B. Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain. Cochrane Database Syst Rev. 2010;(2):CD007431. doi:10.1002/14651858.CD007431.pub2. PMID: 20166095.
Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.