Physical examination maneuver

Physical Exam

Spine Inspection

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Video coming September 2026

How to Perform

With the patient standing and adequately undressed, inspect the spine and back from behind and from the side. Note the alignment of the spinous processes, the level of the shoulders, scapulae, and iliac crests, the normal cervical and lumbar lordosis and thoracic kyphosis, and any lateral curvature, excessive curvature, list, muscle asymmetry, or skin markings.

How to Interpret

Showing 1 of 2 findings

Vertebral Compression Fracture

Increased thoracic kyphosis (a visible humped upper back) with the back of the head held off the wall (wall-occiput distance greater than 0 cm)
Rule in
Somewhat helpful
Rule out
—
Evidence:Limited

References

  • Green AD, Colon-Emeric CS, Bastian L, Drake MT, Lyles KW. Does this woman have osteoporosis? JAMA. 2004;292(23):2890-900. PMID: 15598921.
  • 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.
  • 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.

Related Systems / Regions

MusculoskeletalNeckThorax

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