A 16-year-old gymnast is referred to physical therapy for lo…
A 16-year-old gymnast is referred to physical therapy for low back pain, which has been present for the past 5 months and is progressively worsening. She has not yet had an MRI but chose to pursue physical therapy first. On examination, she demonstrates significant hypermobility throughout the lumbar spine. The pain is localized to the L5-S1 region, where she points to the center of her lower back. Aggravating factors include lumbar extension, gymnastics practice, and competition. Easing factors include heat, ice, and ibuprofen. During the physical examination, the physical therapist notes a step-off (divot) sign during the PAIVM assessment of the lumbar spine at L5. What diagnosis should the physical therapist be most concerned with regarding this patient?