What nonspinal disorders must be ruled out during the examination of a patient with degenerative spondylolisthesis

Degenerative arthritis of the hip joint and peripheral vascular disease. Hip joint arthrosis may cause buttock and thigh pain that mimics the symptoms of spinal stenosis. Assessment of hip joint range of motion can determine whether radiographs are necessary to evaluate the hip joints. If both hip arthritis and degenerative spondylolisthesis are present, injection of the hip joint under fluoroscopic guidance can aid in sorting out which problem is more symptomatic. Peripheral vascular disease can also cause claudication. Assessment of lower extremity peripheral pulses is a routine part of assessment of patients with adult spinal disorders. Vascular claudication is associated with increased muscular exertion independent of trunk position. Symptoms due to vascular claudication typically occur in the distal calf and foot and are not associated with back pain.

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