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September 25, 1926


JAMA. 1926;87(13):1002-1003. doi:10.1001/jama.1926.02680130016004

The localization of pain and sensitiveness to pressure in the small triangular space formed by the midline of the last two lumbar vertebrae and the posterior portion of the iliac crest in many cases of back strain has led us to a more careful study of this area.

In patients, especially those whose occupations or avocations require frequent rotation of the column, such as shoveling or running hoisting machinery, in which the right arm constantly reaches forward to pull levers, and in playing golf, the discovery of a point of great tenderness in this triangle is quite common. It is especially marked along the line of the iliolumbar ligaments on one or both sides, and worse at the point of attachment of this ligament to the ilium. We have been struck with the fact that this occurs particularly in patients with a loose sacro-iliac joint, in cases of spondylolisthesis, and

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