Lumbar

Question 0

Straight Leg Raiser (SLR)

Answer 0

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

Question 1

Hoover Sign

Answer 1

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

Question 2

Goldthwait sign

Answer 2

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

Question 3

Bragard Sign

Answer 3

Positive: Radiating pain in posterior thigh

Indicates: Sciatic radicolopathy

Question 4

Buckling Sign

Answer 4

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

Indicates: Sciatic radiculopathy

Question 5

Bowstring Sign

Answer 5

Positive: Pain in the lumbar region or radiculopathy

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

Question 6

Lasegue Test

Answer 6

Positive: Reproduction of sciatic pain before 60 degrees

Indicates: Sciatica

Question 7

Milgram Test

Answer 7

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

Indicates: Weak abdominal muscles or space occupying lesion

Question 8

Valsalva Maneuver

Answer 8

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)

Question 9

Bechterew Test

Answer 9

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

Indicates: Sciatic radiculopathy

Question 10

Neri Bowing Sign (Neri Sign)

Answer 10

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.

Question 11

Anterior Innominate Test aka Mazion Pelvic Maneuver aka Advancement Sign

Answer 11

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

Question 12

Lewin Standing Test

Answer 12

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

Indicates: Gluteal, lumbosacral, or sacroiliac pathologies

Question 13

Heel Walk

Answer 13

Positive: Inability to perform the test

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

Question 14

Toe Walk

Answer 14

Positive: Inability to perform test

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

Question 15

Ely heel to buttock test (aka Ely sign)

Answer 15

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