Physical examination maneuver

Physical Exam

Spine Inspection

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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

Showing 2 of 5 findings

Lumbar Disc Herniation

Lateral list / sciatic shift
Rule in
InconclusiveWide CI
Rule out
Minimally helpfulDerived CI
Evidence:Moderate

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 helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Moderate

Related Bedside Tests

🎬Video coming soon
Scoliosis Assessment
aka Adams forward bend test
Rule in:VHScoliosis
Rule out:SHScoliosis
🎬Video coming soon
Thoracolumbar Spine and Back Palpation
Rule in:HSpondylolisthesis, MHSpinal Malignancy, NHSacroiliac Joint Pathology +6 more
Rule out:SHSpondylolisthesis, ICSacroiliac Joint Pathology, ICSpinal Malignancy +6 more
🎬Video coming soon
Straight Leg Raise
aka Lasègue sign
Rule in:SHLumbosacral Radiculopathy, NHLumbar Disc Herniation, IECauda Equina Syndrome
Rule out:SHLumbar Disc Herniation, NHLumbosacral Radiculopathy, IECauda Equina Syndrome
🎬Video coming soon
Thoracolumbar Active Range of Motion
Rule in:IEAnkylosing Spondylitis, IELumbar Spinal Stenosis
Rule out:IEAnkylosing Spondylitis, IELumbar Spinal Stenosis
🎬Video coming soon
Calf Circumference
Rule in:HLumbosacral Radiculopathy, SHSarcopenia, MHDeep Vein Thrombosis +1 more
Rule out:SHSarcopenia, MHDeep Vein Thrombosis, NHLumbosacral Radiculopathy +1 more
🎬Video coming soon
FABER Test
aka Patrick test
Rule in:SHSacroiliac Joint Pathology, NHIntra-articular Hip Pathology, IEHip Flexion Contracture +1 more
Rule out:SHSacroiliac Joint Pathology, NHIntra-articular Hip Pathology, IEHip Flexion Contracture +1 more

Related Systems / Regions

BackMusculoskeletalNeckThorax

Related Diagnoses

Ankylosing SpondylitisLumbar Disc HerniationParaspinal Muscle SpasmScoliosisVertebral Compression Fracture

Related Chief Complaints

Acute Back PainBack AsymmetryBack PainBack Pain After a Minor FallBack Pain That Improves with ExerciseBack Pain Worse with StandingBack StiffnessChronic Back Pain in a Young AdultCrooked BackCurved SpineLeaning to One SideLocalized Spinal TendernessLoss of HeightMidline Back TendernessMorning Back StiffnessOne Shoulder HigherPain Radiating Down the LegRib HumpSciaticaStooped PostureSudden Back PainUneven HipsUneven ShouldersUneven WaistlineVisible Spinal CurveWorsening Hunchback

References

  • Siminoski K, Warshawski RS, Jen H, Lee KC. The accuracy of clinical kyphosis examination for detection of thoracic vertebral fractures: comparison of direct and indirect kyphosis measures. J Musculoskelet Neuronal Interact. 2011;11(3):249-256. PMID: 21885900.
  • 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.
  • Vucetic N, Svensson O. Physical signs in lumbar disc hernia. Clin Orthop Relat Res. 1996;(333):192-201. doi:10.1097/00003086-199612000-00020. PMID: 8981896.
  • 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.