Tension Distension Sign (Acevedo’s Sign) for the Diagnosis of Lumbar Facet Syndrome: Technical Note

The treatment of low back pain has evolved from an understanding of its pathophysiology, biomechanics, and therapy. The events that characterize the degenerative cascade of modifications that produce pain are well described. Facet joints are early affected when there is a loss of intervertebral disc height and may present biomechanical overload that translates into pain. Clinical diagnosis of lumbar facet syndrome is not straightforward because there are no specific features other than pain triggered by hyperextension + forced rotation of the lumbar spine in a standing position to suspect it. This implies that its diagnostic confirmation depends on bone scintigraphy and selective anesthetic blockade of the dorsal and medial branches of the joint. In this technical note, we present a new clinical sign (Tension Distension Signo sign/Acevedo's sign) described since 2004.