DIFFERENTIAL-DIAGNOSIS OF THE HIP VS. LUMBAR SPINE - 5 CASE-REPORTS

With recent health care policy changes and the implementation of direc t access in many states, physical therapists must be able to identify pathology that is beyond their scope of practice. The five case report s 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 speciali st 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 joi nt restriction and the ''Sign of the Buttock'' proved useful in differ entiating 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 path ology in patients may be effective; however, further research is neede d to support these claims.