Lumbar Special Test

Question 1

Hoover Sign

Answer 1

+: Lack of counter Pressure on the healthy side

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

Question 2

Straight Leg Raiser (SLR)

Answer 2

+: Radiating pain and/or dull posterior thigh pain

Indicates: Sciatic Radiculopathy or Tight Hamstrings. Positive between 35-70 degrees possible discogenic sciatic radiculopathy. If positive above 70 degrees possible tight hamstrings.

Question 3

Goldthwait Sign

Answer 3

+: Localized pain in the low back or radiating pain down the leg

indicates: Lumbo-sacral or sacroiliac pathology. Pain occurring before the lumbars move indicates sacroiliac problem. Pain occurring after the lumbars move indicates lumbo-sacral problem.

Question 4

Bragard Sign

Answer 4

“I preform a straight leg raiser on my patient. I then lower the leg 5 degrees or until the pain disappears, and sharply dorsiflex the pts foot”

+: Radiating Pain in the posterior thigh.
Indicates: Sciatic radiculopathy

Question 5

Buckling Sign

Answer 5

“I preform a straight leg raiser on my patient.”

+: pain in the posterior thigh with sudden flexion of the leg

Indicates: Sciatic Radiculopathy

Question 6

Bowstrings Sign

Answer 6

+: Pain in the lumbar region or radiculopathy

indicates: Sciatic nerve root compression. Helps rule out tight hamstrings

Question 7

Lasegue Test

Answer 7

+: reproduction of sciatic pain before 60 degrees

indicates: sciatica

Question 8

Milgram Test

Answer 8

+: inability to preform the test and/or pain in the low back

indicates: Weak abdominal muscles or space occupying lesion

Question 9

Bechterew Test

Answer 9

+: reproduction of radicular pain or inability to perform correctly due to tripod sign

indicates: sciatic radiculopathy

Question 10

Neri Bowing Test

Answer 10

+: 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 (Advancement Sign)

Answer 11

+:

1. Radiating pain along the sciatic nerve (either unilateral or bilateral)
2. Low back pain (lumbar or pelvic region

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

+: Radiating Pain down the leg causing flexion of the patients knee or knees

indicates: gluteal, lumboscral or sacral iliac pathologies

Question 13

Heel Walk

Answer 13

+: inability to perform the test

indicates: L4 L5 disc lesion (L5 nerve root)

Question 14

Toe Walk

Answer 14

+: inability to perform the test

indicates: L5 S1 Disc lesion (S1 nerve root)

Question 15

Ely Heel to Buttock Tets

Answer 15

+:

1. Inability to raise the thigh
2. Pain in the anterior thigh
3. Pain in the lumbar region

indicates:

1. iliopsoas spasm
2. inflammation of lumbar nerve roots
3. lumbar nerve root adhesion