Pain from the iliolumbar ligament can be referred to which area on the same side?

• A. Contralateral shoulder
• B. Ipsilateral groin
• C. Ipsilateral hand
• D. Anterior chest

Answer: (D)

Referred pain from a ligament can be felt at a site that shares the same spinal segment innervation, not necessarily right above the source. The iliolumbar ligament involves nerves that enter the spinal cord around the lower thoracic/upper lumbar levels, and pain signals can converge and be felt in a distant, but ipsilateral, trunk area rather than at the back itself. That’s why pain from this ligament can show up on the same side in the anterior chest region.

So the anterior chest on the same side is the best match for this referred-pain pattern, more so than the contralateral shoulder, the ipsilateral hand, or the opposite side chest.