Introduces self
0
1

Confirms name & age of patient
0
1

Explains & gains consent
0
1

Asks if patient suffers from pain, stiffness 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, neurological symptoms or bladder/bowel dysfunction
0
1
2
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, scars, hindfoot deformities
0
1

Inspects sides for fixed flexion deformities and increased kyphosis or lordosis
0
1

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

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

Asks patient to sit down to assess thoracic rotation
0
1

Assesses chest expansion
0
1

Performs straight leg raise for testing sciatic nerve, femoral stretch test for the femoral nerve, Faber’s test for sacroilitis
0
1
2
Offers examination of shoulder and hip, neurovascular exam and history
0
1

Thanks patient and offers help to redress
0
1

Washes hands
0
1

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

Summarises appropriately with only key findings
0
1

Offers appropriate differential diagnoses
0
1