Association Between Trendelenburg Sign and Lumbar MRI Abnormalities

Inclusion Criteria:

• Age between 18 and 65 years.
• Patients who have previously presented to the clinic with a complaint of low back pain.
• Willingness and ability to provide written informed consent for participation in the study.
• Availability of lumbar MRI images obtained within the previous 12 months and accessible for evaluation.

Exclusion Criteria:

• Presence of red flag conditions associated with low back pain, including malignancy, infection, acute trauma, or significant neurological deficits.
• History of lumbar spine surgery.
• Structural spinal anomalies such as sacralization or lumbarization.
• Spinal deformities, including scoliosis.
• Rheumatologic diseases affecting the spine (e.g., axial spondyloarthritis).
• Significant radiculopathy or advanced neurological deficits, and the presence of extruded or sequestrated lumbar disc herniation.
• Clinically significant lumbar spinal stenosis.
• Spondylolysis and/or spondylolisthesis.
• Acute vertebral fracture, compression fracture, or recent fracture associated with severe osteoporosis.
• Hip or pelvic conditions that may directly influence the Trendelenburg sign, including: History of hip arthroplasty or hip surgery, advanced hip osteoarthritis, residual deformity following lower-extremity fracture, significant leg length discrepancy (>2 cm).
• Systemic or neuromuscular disorders, including multiple sclerosis, myopathies, amyotrophic lateral sclerosis (ALS), stroke, or peripheral neuropathies.
• Pregnancy.
• Severe knee or ankle pathology or other conditions causing substantial gait impairment.