Differential diagnosis of the hip vs. lumbar spine: five case reports

The Journal of Orthopaedic and Sports Physical Therapy
M J GreenwoodD L Jones

Abstract

With recent health care policy changes and the implementation of direct access in many states, physical therapists must be able to identify pathology that is beyond their scope of practice. The five case reports presented in this series required the differential diagnosis of hip vs. lumbar spine pathology. All of the cases required a referral from the physical therapist to either the patient's physician or a specialist because of abnormal screening test results. Each referral resulted in a new diagnosis of pathology that was beyond the scope of physical therapy. Cyriax's concepts of capsular and noncapsular patterns of joint restriction and the "Sign of the Buttock" proved useful in differentiating between hip and lumbar spine pathology in each patient. Our clinical experience indicates that utilizing the presence/absence of a capsular pattern and a "Sign of the Buttock" to screen out hip pathology in patients may be effective; however, further research is needed to support these claims.

References

Jan 1, 1996·The Journal of Orthopaedic and Sports Physical Therapy·G L PellecchiaJ Connell

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Citations

Nov 22, 2005·The Journal of Orthopaedic and Sports Physical Therapy·Michael D Ross, Edmond Bayer
Dec 17, 2005·The Journal of Orthopaedic and Sports Physical Therapy·David A Browder, Richard E Erhard
Dec 17, 2005·The Journal of Orthopaedic and Sports Physical Therapy·Matthew B Garber
Feb 24, 2006·The Journal of Orthopaedic and Sports Physical Therapy·Burke GurneyRon Andrews
Jan 28, 2012·The Journal of Orthopaedic and Sports Physical Therapy·William G Boissonnault, Michael D Ross
Apr 19, 2003·Physiotherapy Research International : the Journal for Researchers and Clinicians in Physical Therapy·Maria KlässboGerry Larsson
Dec 23, 2004·Journal of Manipulative and Physiological Therapeutics·Richard E Erhard, Brian Patrick Egloff
Dec 11, 2008·The Journal of Manual & Manipulative Therapy·Leah J BorgerdingWilliam G Boissonnault
Oct 8, 1999·Manual Therapy·K Sims
Nov 3, 2010·The Journal of Orthopaedic and Sports Physical Therapy·Michael D Ross, William G Boissonnault
Jun 2, 2018·Physiotherapy Theory and Practice·Firas MouradJames Dunning
Sep 3, 2019·The Journal of Manual & Manipulative Therapy·Richard RosedaleShawn M Robbins
Dec 14, 2006·Pain Practice : the Official Journal of World Institute of Pain·Phillip S SizerKerry Gilbert
Aug 2, 2017·Annals of Rehabilitation Medicine·Ju Yong KimYongmin Choi

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