(1) Costovertebral angle. (2) Spinous process and interspinous ligament. (3) Region of articular facet (fifth lumbar to first sacral). (4) Dorsum of sacrum.

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(1) Costovertebral angle. (2) Spinous process and interspinous ligament. (3) Region of articular facet (fifth lumbar to first sacral). (4) Dorsum of sacrum. (5) Region of iliac crest. (6) Iliolumbar angle. (7) Spinous processes of fifth lumbar and first sacral vertebrae (tenderness = faulty posture or occasionally spina bifida occulta). (8) Region between posterior superior and posteroinferior spines. Sacroiliac ligaments (tenderness = sacroiliac sprain, often tender, with fifth lumbar or first sacral disc). (9) Sacrococcygeal junction (tenderness = sacrococcygeal injury; i.e., sprain or fracture). (10) Region of sacrosciatic notch (tenderness = fourth or fifth lumbar disc rupture and sacroiliac sprain). (11) Sciatic nerve trunk (tenderness = ruptured lumbar disc or sciatic nerve lesion). Source: Chapter 11. Pain in the Back, Neck, and Extremities, Adams and Victor's Principles of Neurology, 10e Citation: Ropper AH, Samuels MA, Klein JP. Adams and Victor's Principles of Neurology, 10e; 2014 Available at: https://neurology.mhmedical.com/DownloadImage.aspx?image=/data/books/ropp10/ropp10_c011f002.png&sec=45426057&BookID=690&ChapterSecID=45424419&imagename= Accessed: November 05, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved