Which physical examination finding is commonly positive in spinal osteomyelitis?

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Spinal osteomyelitis commonly causes focal tenderness along the spine that is easiest to elicit by tapping (percussion) the spinous processes or by palpating directly over the affected vertebral level. The infection inflames the bone and adjacent disc space, so pressing on that area provokes pain, making spinal percussion or direct pressure the most typical positive finding.

Other tests aren’t as characteristic: a straight leg raise targets nerve root tension and disc herniation rather than infection; muscle strength testing may stay normal early on unless there’s significant compression or abscess; and the Romberg test assesses proprioception and balance rather than localized vertebral infection.