Brudzinski’s Sign: Difference between revisions
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== Description == | == Description == | ||
Brudzinski's sign is one of the physically demonstrable symptoms of meningitis. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed.<ref>http://www.nlm.nih.gov/medlineplus/ency/imagepages/19069.htm</ref> | '''Brudzinski's sign''' is one of the physically demonstrable symptoms of meningitis. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed.<ref>http://www.nlm.nih.gov/medlineplus/ency/imagepages/19069.htm</ref><ref>Manmohan Mehndiratta, Rajeev Nayak, Hitesh Garg, Munish Kumar, and Sanjay Pandey (2012). Appraisal of Kernig's and Brudzinski's sign in meningitis.Ann Indian Acad Neurol. 2012 Oct-Dec; 15(4): 287–288. | ||
doi: 10.4103/0972-2327.104337</ref> | |||
== Purpose == | == Purpose == | ||
'''Brudzinski's sign''' is used to diagnose [https://physio-pedia.com/Meningitis?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal#share '''meningitis''']<br> | |||
== Technique == | |||
To perform the '''Brudzinski's sign''' | |||
'''Step 1.''' Patient in supine position | |||
'''Step 2.''' Gently grasp the patient's head from behind and place the other hand on the patient's chest | |||
'''Step 3.''' Gently flex the neck, bringing chin to chest | |||
'''Step 4.''' Positive sign is involuntary flexing of hips and knees (an involuntary reaction to lessen the stretch on the inflamed meninges)<br><br> | |||
{{#ev:youtube|uJDxuYylH3c}} | {{#ev:youtube|uJDxuYylH3c}} | ||
== Evidence | == Evidence == | ||
The study was done on 297 adults with suspected meningitis to determine the diagnostic accuracy of '''[https://physio-pedia.com/Kernig's_Sign?utm_source=physiopedia&utm_medium=related_articles&utm_campaign=ongoing_internal#share Kernig's sign], Brudzinski's sign,''' and '''Nuchal rigidity''' for meningitis And the study shows kernig's sign has diagnostic value of | |||
Sensitivity | [https://physio-pedia.com/Test_Diagnostics#share '''Sensitivity'''] '''5%'''<ref name=":0">Karen E. Thomas, Rodrigo Hasbun, James Jekel, Vincent J. Quagliarello, The Diagnostic Accuracy of Kernig's Sign, Brudzinski's Sign, and Nuchal Rigidity in Adults with Suspected Meningitis, ''Clinical Infectious Diseases'', Volume 35, Issue 1, 1 July 2002, Pages 46–52, <nowiki>https://doi.org/10.1086/340979</nowiki></ref> | ||
[https://physio-pedia.com/Test_Diagnostics#share '''Specificity'''] '''95%'''<ref name=":0" /> | |||
< | [https://physio-pedia.com/Test_Diagnostics#share '''Positive predictive value'''] '''27%'''<ref name=":0" /> | ||
== References | [https://physio-pedia.com/Test_Diagnostics#share '''Negative predictive value'''] '''72%'''<ref name=":0" /> | ||
The results of this study shows that the diagnostic accuracy of Kernig's sign and Brudzinski's sign was poor for patients with moderate and severe meningeal inflammation and patients with microbiological evidence of CSF infection. And also patients with severe meningitis on the basis of laboratory evidence both Kernig's sign and Brudzinski's sign as low diagnostic value.[3] | |||
Another study suggest that Kernig's sign and Brudzinski's sign as low sensitivity and high specificity for diagnosing meningitis.<ref name=":1">Mehndiratta M, Nayak R, Garg H, Kumar M, Pandey S. Appraisal of Kernig's and Brudzinski's sign in meningitis. ''Ann Indian Acad Neurol''. 2012;15(4):287-288. doi:10.4103/0972-2327.104337</ref> | |||
* low sensitivity suggest when both sign absent should not conclude that there is no evidence of meningitis<ref name=":1" /> | |||
* high specificity suggest when both sign is present there is a high likelihood for meningitis.<ref name=":1" /> | |||
* In clinical practice both kernig's and brudzinski's sign are frequently performed together.<ref name=":1" /> | |||
== References == | |||
#David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014. | |||
<references /> | <references /> | ||
[[Category:Special_Tests]] | [[Category:Special_Tests]] |
Latest revision as of 20:54, 3 September 2020
Original Editor Oyemi Sillo
Top Contributors - Sweta Christian, Anas Mohamed, Oyemi Sillo, Kim Jackson, 127.0.0.1, Admin, Evan Thomas and WikiSysop
Description[edit | edit source]
Brudzinski's sign is one of the physically demonstrable symptoms of meningitis. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed.[1][2]
Purpose[edit | edit source]
Brudzinski's sign is used to diagnose meningitis
Technique[edit | edit source]
To perform the Brudzinski's sign
Step 1. Patient in supine position
Step 2. Gently grasp the patient's head from behind and place the other hand on the patient's chest
Step 3. Gently flex the neck, bringing chin to chest
Step 4. Positive sign is involuntary flexing of hips and knees (an involuntary reaction to lessen the stretch on the inflamed meninges)
Evidence[edit | edit source]
The study was done on 297 adults with suspected meningitis to determine the diagnostic accuracy of Kernig's sign, Brudzinski's sign, and Nuchal rigidity for meningitis And the study shows kernig's sign has diagnostic value of
Specificity 95%[3]
Positive predictive value 27%[3]
Negative predictive value 72%[3]
The results of this study shows that the diagnostic accuracy of Kernig's sign and Brudzinski's sign was poor for patients with moderate and severe meningeal inflammation and patients with microbiological evidence of CSF infection. And also patients with severe meningitis on the basis of laboratory evidence both Kernig's sign and Brudzinski's sign as low diagnostic value.[3]
Another study suggest that Kernig's sign and Brudzinski's sign as low sensitivity and high specificity for diagnosing meningitis.[4]
- low sensitivity suggest when both sign absent should not conclude that there is no evidence of meningitis[4]
- high specificity suggest when both sign is present there is a high likelihood for meningitis.[4]
- In clinical practice both kernig's and brudzinski's sign are frequently performed together.[4]
References[edit | edit source]
- David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
- ↑ http://www.nlm.nih.gov/medlineplus/ency/imagepages/19069.htm
- ↑ Manmohan Mehndiratta, Rajeev Nayak, Hitesh Garg, Munish Kumar, and Sanjay Pandey (2012). Appraisal of Kernig's and Brudzinski's sign in meningitis.Ann Indian Acad Neurol. 2012 Oct-Dec; 15(4): 287–288. doi: 10.4103/0972-2327.104337
- ↑ 3.0 3.1 3.2 3.3 Karen E. Thomas, Rodrigo Hasbun, James Jekel, Vincent J. Quagliarello, The Diagnostic Accuracy of Kernig's Sign, Brudzinski's Sign, and Nuchal Rigidity in Adults with Suspected Meningitis, Clinical Infectious Diseases, Volume 35, Issue 1, 1 July 2002, Pages 46–52, https://doi.org/10.1086/340979
- ↑ 4.0 4.1 4.2 4.3 Mehndiratta M, Nayak R, Garg H, Kumar M, Pandey S. Appraisal of Kernig's and Brudzinski's sign in meningitis. Ann Indian Acad Neurol. 2012;15(4):287-288. doi:10.4103/0972-2327.104337