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Orthopedic Special Tests > Lumbar > Flashcards

Flashcards in Lumbar Deck (16):

Hoover Sign

Positive: Lack of counter-pressure on the healthy side

Indicates: Lack of organic basis for paralysis (malingering/hysteria)
With organic hemiplegia, the patient will still exert downward pressure when attempting to raise paralyzed leg


Straight Leg Raiser (SLR)

Positive: Radiating pain and/or dull posterior thigh pain.

Indicates: Sciatic radiculopathy or tight hamstrings. Positive between 35-70 degrees indicates possible discogenic sciatic radiculopathy. Positive at greater than 70 degrees indicates tight hamstrings


Goldthwait sign

Positive: Localized pain, low back, or radiating pain down the leg

Indicates: Lumbo-sacral or sacroiliac pathology. Pain occurring after the lumbar spinouses move indicates possible lumbo-sacral problem. Pain occuring before the lumbars move indicates possble sacroiliac problem


Bragard Sign

Positive: Radiating pain in posterior thigh

Indicates: Sciatic radicolopathy


Buckling Sign

Positive: Pain in the posterior thigh with sudden knee flexion (buckle)

Indicates: Sciatic radiculopathy


Bowstring Sign

Positive: Pain in the lumbar region or radiculopathy

Indicates: Sciatic nerve root compression, helps rule out tight hamstrings


Lasegue Test

Positive: Reproduction of sciatic pain before 60 degrees

Indicates: Sciatica


Milgram Test

Positive: Inability to perform test and/or low back pain

Indicates: Weak abdominal muscles or space occupying lesion


Valsalva Maneuver

Positive: Radiating pain from site of lesion (usually recreating the complaint in cervical or lumbar area of the spine).

Indicates: Space occupying lesion (e.g. Disc pathology)


Bechterew Test

Positive: Reproduction of radicular pain or inability to perform correctly due to tripod sign.

Indicates: Sciatic radiculopathy


Neri Bowing Sign (Neri Sign)

Positive: Pain accompanied by flexion of the knee on the affected side and body rotation away from the affected side.

Indicates: Positive with a variety of low back pathologies. Hamstring tension on the pelvis may trigger the response.


Anterior Innominate Test aka Mazion Pelvic Maneuver aka Advancement Sign

Positive: The inability to bend at the waist more than 45 degrees because of either/or
1) radiating pain along the sciatic nerve, either unilateral or bilateral
2) Low back pain (lumbar or pelvic regions

Indicates: 1) Sciatic neuralgia or radiculopathy, etc., possibly due to lumbar disc pathology
2) Anterior (rotational) displacement of the ilium relative to the sacrum


Lewin Standing Test

Positive: Radiating pain down the leg causing flexion of the patient's knee or knees.

Indicates: Gluteal, lumbosacral, or sacroiliac pathologies


Heel Walk

Positive: Inability to perform the test

Indicates: L4-L5 disc lesion (L5 nerve root)


Toe Walk

Positive: Inability to perform test

Indicates: L5-S1 disc lesion (S1 nerve root)


Ely heel to buttock test (aka Ely sign)

Positive: 1) inability to raise the thigh
2) Pain in the anterior thigh
3)Pain in the lumbar regions

Indicates: 1) Iliopsoas spasm
2) Inflammation of the lumbar nerve roots
3) Lumbar nerve root adhesions