Detecting joint instability

It is very difficult to detect spondylolisthesis (or anterolisthesis) clinically. Although it is often associated with anterior translation of the thoracic cage, this doesn't entail that every patient that exhibits flexion of the thoracic cage suffers from joint instability.

Lateral listhesis (also called rotational subluxation) is most often associated with scoliosis. While it's impossible to clinically detect lateral listhesis itself, it is possible to detect scoliosis using the visual indicators provided in the DETECTING SCOLIOSIS section. 

However, certain less clinical signs, including a  sore back or neck, as well as certain neurological symptoms associated with spinal compression (central or lateral spinal stenosis) may point to the presence of joint instability. Only an x-ray can confirm the diagnosis.  

X-ray of an anterolisthesis (spondylolisthesis) X-ray of a lateral listhesis (rotational subluxation)

X-ray of anterolisthesis (spondylolisthesis)

X-ray of lateral listhesis (rotational subluxation)