1/9/2020 Spine Exam (Back & Neck) - OSCE Stations

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Spine Exam (Back & Neck)

Introduces self 0 1

Con rms name & age of patient 0 1

Explains & gains consent 0 1

Asks if patient su ers from pain, sti ness or reduced range of movement in the back 0 1

Asks if patient has had previous trauma to the back, is waking up at night with pain, 0 1 2
neurological symptoms or bladder/bowel dysfunction

Washes hands 0 1

Exposes patient fully and asks them to stand 0 1

General inspection around bed and patient (walking aids, obvious scars, wasting or deformities) 0 1
Asks patient to walk to the end of room and turn 0 1
Comments on patient’s speed, the phases of walking, stride length and arm swing 0 1 2

Inspects front for shoulder/hip alignment, limb-limb discrepancy, varus/valgus deformity 0 1

Inspects back for wasting of muscles (trapezius, paraspinal, gluteal, calf), scoliosis, skin changes, 0 1
scars, hindfoot deformities
Inspects sides for xed exion deformities and increased kyphosis or lordosis 0 1

Inspects back for shoulder/hip/knee alignment, kyphoses and lordoses, scoliosis, scars, skin 0 1 2
changes, wasting of muscles (trapezius, paraspinal, gluteal)

Feels for temperature, tenderness and alignment of the spinal processes 0 1

Feels for tenderness and tone of the paravertebral muscles 0 1
Assesses cervical exion, lateral exion, rotation and extension 0 1

Whilst standing checks for spinal exion using the modi ed Schober’s test and lateral exion 0 1 2
Supports body whilst checking for extension of the back 0 1

Asks patient to sit down to assess thoracic rotation

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1/9/2020 Spine Exam (Back & Neck) - OSCE Stations
Assesses chest expansion 0 1

Performs straight leg raise for testing sciatic nerve, femoral stretch test for the femoral nerve, 0 1 2
Faber’s test for sacroilitis

O ers examination of shoulder and hip, neurovascular exam and history 0 1

Thanks patient and o ers help to redress 0 1

Washes hands 0 1
O ers next step (imaging: 2 plain x rays for bony pathology or CT if indicated, MRI for soft 0 1
tissue)

Summarises appropriately with only key ndings 0 1

O ers appropriate di erential diagnoses 0 1

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