To distinguish if the back pain is coming from the sacroiliac joint rather than the LS spine area you can place the patient supine on the table near the edge. Ask the patient to then dangle the leg off the edge of the table (you may need to assist the patient to do this). Check each leg off the opposite sides of the exam table. If this "dangle" test produces pain this is indicative of the SI joint as the source of the pain rather than the LS spine.
If a patient is having radicular signs with the back pain, get a CT scan to rule out disc pathology. Lastly, if a patient is 50 years of age or older order a CBC, urinalysis, sedimentation rate, and a chemistry panel. Also do these same tests on a very young patient.
Updated January 8, 1999
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