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Academic Subject University Exam High-Yield

Clinical Differentiation: True Lumbar Radiculopathy vs Piriformis Syndrome vs SI Joint Dysfunction

Topic Summary & Background: A 36-year-old software engineer presents with right buttock and posterior thigh pain radiating to calf. What special test battery and neurological reflexes conclusively isolate nerve root compression from extraspinal entrapment?

Key Discussion Questions:
  • Comparison of Straight Leg Raise (SLR) + Braggard's vs FAIR (Flexion-Adduction-Internal Rotation) test.
  • Laslett's SIJ cluster (Distraction, Thigh Thrust, Compression, Sacral Thrust) validity rules.
  • Dermatomal / Myotomal neurological findings (L5 vs S1) vs trigger point referral patterns.
Standard Clinical Consensus: Viva Reference Points: True radiculopathy demonstrates positive Slump test, dermatomal sensory changes (L5 dorsum of foot / S1 lateral border), and myotomal weakness (extensor hallucis longus or calf). Piriformis syndrome reproduces sciatic pain during FAIR test or resisted abduction in seated position (Pace's sign) with normal spine ROM.
DM
Dr. Meera Kulkarni, MPT (Academic HOD)
Professor • Just now
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