Orthopedic Diagnosis: Lumbar Spine Flashcards
1
Q
Hoover Sign
A
- 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 the paralyzed leg
2
Q
Straight Leg Raiser
A
- Positive: Radiating pain and/or dull posterior thigh pain
- Indicates: Sciatic radiculopathy or tight hamstrings
- Positive between 35-70º = possible discogenic sciatic radiculopathy
- Positive > 70º = tight hamstrings
- Indicates: Sciatic radiculopathy or tight hamstrings
3
Q
SLR
A
- Positive: Radiating pain and/or dull posterior thigh pain
- Indicates: Sciatic radiculopathy or tight hamstrings
- Positive between 35-70º = possible discogenic sciatic radiculopathy
- Positive > 70º = tight hamstrings
- Indicates: Sciatic radiculopathy or tight hamstrings
4
Q
Goldthwait Sign
A
- Positive: Localized pain, low back or radiating pain down the leg
- Indicates: Lumbosacral or sacroiliac pathology
- Pain occuring after the lumbar spinouses move = possible lumbosacral problem
- Pain occuring before the lumbars move = possible scroiliac problem
- Indicates: Lumbosacral or sacroiliac pathology
5
Q
Bragard Sign
A
- Positive: Radiating pain in posterior thigh
- Indicates: Sciatic radiculopathy
6
Q
Buckling Sign
A
- Positive: Pain in the posterior thigh with sudden knee flexion (buckle)
- Indicates: Sciatic radiculopathy
7
Q
Bowstring Sign
A
- Positive: Pain in the lumbar region or radiculopathy
- Indicates: Sciatic nerve root compression, helps rule out tight hamstrings
8
Q
Lasegue Test
A
- Positive: Reproduction of sciatic pain before 60º
- Indicates: Sciatica
9
Q
Milgram Test
A
- Positive: Inability to perform the test and/or low back pain
- Indicates: Weak abdominal muscles or space occupying lesion
10
Q
Valsalva Maneuver
A
- 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)
11
Q
Bechterew Test
A
- Positive: Reproduction of radicular pain or inability to perform correctly due to tripod sign
- Indicates: Sciatic radiculopathy
12
Q
Neri Bowing Test
A
- Positive: Pain accompanied by flexion of the knee on th 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
13
Q
Neri Sign
A
- 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
14
Q
Anterior Innominate Test
A
- Positive: The inability to bend at the waist more than 45º becuase of either/or
- Radiating pain along the sciatic nerve, either unilateral or bilateral
- Indicates: Sciatic neuralgia or radiculopathy, etc., possibly due to lumbar disc pathology
- Low back pain (lumbar or pelvic regions)
- Indicates: Anterior (rotational) displacement of the ilium relative to the sacrum
- Radiating pain along the sciatic nerve, either unilateral or bilateral
15
Q
Mazion Pelvic Maneuver
A
- Positive: The inability to bend at the waist more than 45º, because of either/or
- Radiating pain along the sciatic nerve, either unilateral or bilateral
- Indicates: Sciatic neuralgia or radiculopathy, etc., possibly due to lumbar disc pathology
- Low back pain (lumbar or pelvic regions)
- Indicates: Anterior (rotational) displacement of the ilium relative to the sacrum
- Radiating pain along the sciatic nerve, either unilateral or bilateral
16
Q
Advancement Sign
A
- Positive: The inability to bend at the waist more than 45º because of either/or
- Radiating pain along the sciatic nerve, either unilateral or bilateral
- Indicates: Sciatic neuralgia or radiculopahty, etc., possibly due to lumbar disc pathology
- Low back pain (lumbar or pelvic regions)
- Indicates: Anterior (rotational) displacement of the ilium relative to the sacrum
- Radiating pain along the sciatic nerve, either unilateral or bilateral
17
Q
Lewin Standing Test
A
- Positive: Radiating pain down the leg causing flexion of the patient’s knee or knees
- Indicates: Gluteal, lumbosacral or sacroiliac pathologies
18
Q
Heel Walk
A
- Positive: Inability to perform the test
- Indicates: L4-L5 disc lesion (L5 nerve root)
19
Q
Toe Walk
A
- Positive: Inability to perform the test
- Indicates: L5-S1 disc lesion (S1 nerve root)
20
Q
Ely Heel to Buttock Test
A
- Positive: Inability to raise the thigh
- Indicates: Iliopsoas spasm
- Positive: Pain in the anterior thigh
- Indicates: Inflammation of the lumbar nerve roots
- Positive: Pain in the lumbar region
- Indicates: Lumbar nerve root adhesions
21
Q
Minor Sign
A
- Positive: Knee flexion of affected leg which supporting upper body weight (hand on back or thigh) on unaffected side
- Indicates: Sciatica, lumbosacral or sacroiliac joint lesion
22
Q
Belt Test
A
- Positive: Low back pain while bending with the sacrum stabilized and unstabilized
- Indicates: Lumbar involvement
- Positive: Low back pain during sacrum non-stabilized bending and no pain during sacrum stabilized bending
- Indicates: Pelvic involvement
23
Q
Supported Adam Test
A
- Positive: Low back pain while bending with the sacrum stabilized and unstabilized
- Indicates: Lumbar involvement
- Positive: Low back pain during sacrum non-stabilized bending and no pain during sacrum stabilized bending
- Indicates: Pelvic involvement
24
Q
Supported Forward Bending Test
A
- Positive: Low back pain while bending with the sacrum stabilized and unstabilized
- Indicates: Lumbar involvement
- Positive: Low back pain during sacrum stabilized bending and no pain during sacrum stabilized bending
- Indicates: Pelvic involvement
25
Q
Kemp Test
A
- Positive: Pain usually radicular, recreating existing sciatic pain
- Indicates: Disc protrusion
- In medial disc protrusion Kemps will be positive as the patient is leaning away from the side of pain
- In lateral disc protrusion Kemps will be positive as the patient is leaning into the side of pain
- Indicates: Disc protrusion
- Positive: Local pain
- Indicates: Lumbar spasm or facet capsulitis
26
Q
Lindner Sign
A
- Positive: Pain along sciatic distribution or sharp diffuse leg pain
- Indicates: Sciatic radiculopathy
27
Q
Turyn Sign
A
- Positive: Pain in the gluteal region or radiating sciatic pain
- Indicates: Sciatic radiculopathy
28
Q
Sicard Sign
A
- Positive: Posterior thigh and leg pain
- Indicates: Sciatic radiculopathy (usually from a disc lesion)
29
Q
Bonnet Sign
A
- Positive: Pain in posterior thigh or leg
- Indicates: Immediate pain is sciatic neuropathy from piriformis syndrome
30
Q
Fajersztajn Test
A
- Positive: Pain down affected leg (cross-over sign)
- Indicates: Medial disc protrusion
- Positive: Decrease in pain down affected leg
- Indicates: Lateral disc protrusion
31
Q
Well-Leg-Raising Test of Fajersztajn
A
- Positive: Pain down affected leg (cross-over sign)
- Indicates: Medial disc protrusion
- Positive: Decrease in pain down affected leg
- Indicates: Lateral disc protrusion
32
Q
Cross-Over Sign
A
- Positive: Pain down affected leg (cross-over sign)
- Indicates: Medial disc protrusion
- Positive: Decrease in pain down affected leg
- Indicates: Lateral disc protrusion
33
Q
Femoral Stretch Test
A
- Positive: Pain on the anterior portion of the thigh
- Indicates: Traction on the femoral nerve indicating involvement of the 2nd, 3rd and 4th lumbar nerve roots
34
Q
Femoral Nerve Traction Test
A
- Positive: Pain on the anterior portion of the thigh
- Indicates: Traction on the femoral nerve indicating involvement of the 2nd, 3rd and 4th lumbar nerve roots
35
Q
Naffziger Test
A
- Positive: Radicular pain (typically in lumbars, possibly cervical or thoracic)
- Indicates: Space occupying lesion
