... - a fall from a motorbike where he slid on his back and into a tree also 7 years ago. X-rays were taken immediately after the accident and revealed no abnormality. Initial Examination Findings: Postural examination revealed a level pelvis and significant lower right shoulder. He also had rounded shoulder posture and forward head carriage His range of motion was normal with no aggravation of pain. Achilles reflex was grade I on the left. Kemps test was performed and revealed ache in L3 region on the left. Hypertonicity and tenderness was noted in Paraspinal, Quadratus Lumborum and Piriformis muscles bilaterally and L2/3 and L3/4 joints were restricted and painful on joint play. X-rays were performed and revealed slight retrolisthesis of L2 on L3. Differential Diagnosis: Working diagnosis was chronic facet syndrome with sub acute exacerbation with associated hypertonic Paraspinal and Piriformis muscles. Other possibilities included: Piriformis syndrome, L2/3 subluxation, Sacroiliac Joint Dysfunction, myofacial ...

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