Evaluation of this patient should include a complete history of her recent fall, how it happened, where her body was affected when it hit the ground, her symptoms and symptom history, and what position her body was in after the fall. Once that information is discerned, examination should include palpation of the soft tissues of the entire right foot, ROM of the foot and ankle, neurological evaluation of the lumbar and sacral plexus including but not limited to DTR, dermatome and muscle testing of the lower extremity, spinal evaluation and myofascial palpation for the entire lower extremity including the spine, right and left hips and knees.

Physical Examination Findings: Cervical, thoracic and lumbar spine fixations and associated muscle spasms were consistent with prior fixations that were currently under care, with the addition of left lower sacroiliac joint fixation and slight left femur head misalignment into the acetabulum. There was bruising to her left elbow, but no fixations or spasms were evident. There was no injury to her left shoulder.

The patient also presented with a right upper sacroiliac joint fixation with associated muscle spasms of the right gluteal muscles and right quadratus lumborum that was not present prior to the fall. The piriformis muscle was not involved. In addition, this patient had pain at the posterior proximal right fibula upon palpation with associated muscle spasms of the right peroneal muscles and right lateral head of the gastrocnemius. This patient had no pain upon palpation of the muscles of the right thigh.

Muscle test evaluation and ROMs of the right foot and ankle were within normal limits. There was no pain upon palpation to soft tissue structures at the top of the foot. There was no alteration of gait. There were no fixations of the bones of the foot and ankle. DTR were normal of the quadriceps and Achilles reflexes, there was hyperesthesia of the dorsum of her foot when palpated.

Question: What Orthopedic tests would you perform in your clinic to rule in or out any lumbar and sacral plexus nerve compression related issues at the spine and pelvis?