Lumbars

Question 1

Hoover sign

Answer 1

“This test is used to differentiate organic versus hysterical leg paralysis”

P: Lack of counter-pressure on the healthy side

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

Question 2

Straight leg raiser (SLR)

Answer 2

P: Radiating pain and/or dull posterior thigh pain

I: Sciatic radiculopathy or tight hamstrings. Positive between 35-70 degrees = possible discogenic radiculopathy; >70 degrees = tight hamstrings.

Question 3

Goldthwait sign

Answer 3

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

I: A lumbosacral or sacro-iliac pathology. Pain occurring after the lumbar spinouses move = possible lumbo-sacral problem. Pain occurring before the lumbars move = possible sacro-iliac problem.

Question 4

Bragard sign

Answer 4

S: Radiating pain in the posterior thigh

I: Sciatic radiculopathy

Question 5

Buckling sign

Answer 5

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

I: Sciatic radiculopathy

Question 6

Bowstring sign

Answer 6

P: Pain in the lumbar region or radiculopathy

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

Question 7

Lasague test

Answer 7

P: Reproduction of sciatic pain before 60 degrees

I: Sciatica

Question 8

Milgram test

Answer 8

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

I: Weak abdominal muscles or space occupying lesion

Question 9

Valsalva maneuver (lumbar)

Answer 9

P: Radiating pain from site of lesion (usually recreating the complaint in cervical or lumbar areas of the spine)

I: Space occupying lesion (i.e. disc pathology)

Question 10

Beckterew test

Answer 10

P: Reproduction of radicular pain or inability to perform incorrectly due to tripod sign

I: Sciatic radiculopathy

Question 11

Anterior Innominate test

Mazion pelvic maneuver; Advancement sign

Answer 11

The inability to bend at the waist more than 45 degrees because of either/or:

P (1): Radiating pain along the sciatic nerve, either unilateral or bilateral
I (1): Sciatic neuralgia or radiculopathy etc., possibly due to lumbar disc pathology

P (2): Low back pain (lumbar or pelvic regions)
I (2): Anterior (rotational) displacement of the ilium relative to the sacrum.

Question 12

Lewing standing test

Answer 12

P: Radiating pain down the leg causing flexion of the patients knee or knees

I: Gluteal, lumbosacral, or sacroiliac pathologies.

Question 13

Neri bowing test (Neri sign)

Answer 13

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

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

Question 14

Heel walk

Answer 14

P: Inability to perform test

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

Question 15

Toe walk

Answer 15

P: Inability to perform test

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

Question 16

Ely heel to buttock

Answer 16

P (1): Inability to raise the thigh
I (1): Iliopsoas spasm

P (2): Pain in the anterior thigh
I (2) Inflammation of the lumbar roots

P (3): Pain in the lumbar region

I (3): Lumbar nerve root adhesions