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Vascular Trauma
Published in James Michael Forsyth, How to Be a Safe Consultant Vascular Surgeon from Day One, 2023
Circulation → Heart rate 100, blood pressure 100/80 mmHg. Can feel radial pulses and all lower limb pulses bilaterally. Abdomen soft and non-tender, non-distended. No obvious long bone fractures. Pelvis not tender. Patient can straight leg raise bilaterally.
Lumbar Stenosis
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
Finally, I would perform provocative ‘special’ tests. These include the straight leg raise (SLR) (done with the patient supine or sitting), which if positive would lead to the reproduction of pain and paraesthesia in the affected area at 30–70 degrees of flexion. Lesegue’s sign is the aggravation of symptoms on SLR with ankle dorsiflexion.
Musculoskeletal and Soft-Tissue Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Assess for any reduction in straight-leg raise (SLR), suggesting sciatic nerve-root irritation. Inability to leg raise more than 30° due to pain going down the leg is abnormal.Remember that being able to sit up in bed with the legs out straight is equivalent to a SLR of 90° on both sides.
Digital physical therapy practice and payment during the COVID-19 pandemic: A case series
Published in Physiotherapy Theory and Practice, 2023
For Patient 1, gait observation revealed a bilateral Trendelenburg sign, and impact force at heel strike was observed, which caused hinging of the lumbar spine into extension. Lumbar active range of motion (AROM) was full and painless in flexion, lateral flexion, and rotation; but lumbar extension was limited to 50% and painful. Posterior-anterior pressure in prone at L5 reproduced the patient’s familiar pain. Prone instability testing was positive. Straight leg raise testing, hip passive range of motion testing, and sacroiliac joint testing were all judged to be normal and painless. Hip abduction strength testing could not be conducted without causing LBP. The patient was provisionally diagnosed with persistent LBP and movement coordination impairments (Delitto et al., 2012).
Factors associated with the recurrence of lumbar disk herniation: non-biomechanical–radiological and intraoperative factors
Published in Neurological Research, 2023
Anas Abdallah, Betül Güler Abdallah
Over the study period, 988 patients received 1139 LDs. Among them, a total of 816 (386 men, 430 women) consecutive patients who received LD for 842 LDHs met the inclusion criteria of the study (Figure 1). Fifty-eight patients were included in group 1, 26 in group 2, and 732 in group 3. The mean follow-up period was 72.8 ± 7.3 (61–89) months. The mean age at the first LD was 46.9 ± 12.1 (17–82) years. The mean pain-free period was 39.3 ± 8.9 (7–82) months. A straight leg raise test was positive in 69.1% of the patients. The most commonly recorded clinical symptom was leg pain which was observed in all patients. The baseline demographic and clinical characteristics of participants are presented in Table 1. A total of 792 (97.1%) patients received a single-level LD in the first surgery. The first, second, and third recurrence rates were 10.3%, 1.7%, and 0.86%, respectively. The first recurrence rates within the first PO24M and after PO24M were 7.1% and 3.2%, respectively (Figure 4 and Table 2).
Physiotherapist management of a patient with spastic perineal syndrome and subsequent constipation: a case report
Published in Physiotherapy Theory and Practice, 2021
Shankar Ganesh, Mritunjay Kumar
The patient had exaggerated thoracic kyphosis and anterior pelvic tilt. The posterior superior iliac spine on the left side was found inferior compared to the right-hand side (Petty and Moore, 2001) (Figure 1). There was an apparent limb shortening of 3 cms on the left lower limb (Magee, 2008). The sacrum was found to have a right-on-right forward torsion with L5 rotated to the left. The lumbar spring test was negative (Magee, 2008). The straight leg raise was found to be limited on the left side (< 30 degrees). Freiberg sign was positive on the left side (Magee, 2008). There was a loss of end range of motion during lumbar forward flexion. The active movements of hips were normal except left hip internal rotation which was limited (30 degrees on the left side compared to 40 degrees on the right; measured using a goniometer in the prone position). Maitland posterior-anterior mobilization to the spine showed reduced intervertebral segmental motions in the lower thoracic (T 10–12) and lumbar region (L1-5). The left piriformis muscle and bilateral hip flexors were tight (Magee, 2008) and palpation of these muscles revealed local tenderness. No other soft tissue impairments were identified.