Clinical Utility of Physical Examination Findings in Pediatric and Adolescent Acute Spondylolysis

This study evaluates the clinical accuracy of physical examination and patient characteristics associated with prevalence of acute spondylolysis in patients who present with lumbar back pain confirmed via MRI. A higher prevalence of acute spondylolysis was observed across several subgroups, including males, early to mid-adolescents, those with shorter symptom duration, and those demonstrating both hyperextension and single-leg hopping pain. Incorporating both maneuvers improved diagnostic accuracy for identifying acute spondylolysis. Findings demonstrate that both hyperextension and single-leg hopping pain may warrant advanced imaging to rule out acute spondylolysis as a cause of lumbar back pain.