Kernig's Sign: Difference between revisions

(added evidence)
No edit summary
Line 33: Line 33:
[https://physio-pedia.com/Test_Diagnostics#share '''Negative predictive value'''] '''72%'''<ref name=":0" />  
[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 '''[https://physio-pedia.com/Brudzinski%E2%80%99s_Sign?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal#share 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 '''[https://physio-pedia.com/Brudzinski%E2%80%99s_Sign?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal#share Brudzinski's sign]''' as low diagnostic value.<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.<ref name=":0" />


Manmohan Mehndiratta, Rajeev Nayak, Hitesh Garg, Munish Kumar, and Sanjay Pandey.[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3548367/ Appraisal of Kernig's and Brudzinski's sign in meningitis]. &nbsp;Ann Indian Acad Neurol. 2012 Oct-Dec; 15(4): 287–288.  
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" />
Thirunavukkarasu Arun Babu. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788317/ Improved sensitivity of Kernig's and Brudzinski's sign in diagnosing meningitis in children]. &nbsp;<span style="line-height: 1.5em;">Ann Indian Acad Neurol. 2013 Jul-Sep; 16(3): 460–461.
* 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" />


<br>  
<br>  

Revision as of 20:37, 3 September 2020

Original Editor ­ Oyemi Sillo

Top Contributors - Admin, Oyemi Sillo, Kim Jackson, Anas Mohamed, Evan Thomas, Joao Costa, 127.0.0.1, Daphne Jackson, WikiSysop, Aminat Abolade and Nupur Smit Shah

Description[edit | edit source]

Kernig's sign is one of the physically demonstrable symptoms of meningitis. Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.[1]

Purpose[edit | edit source]

Kernig's sign is used to diagnose meningitis

Technique[edit | edit source]

To elicit the Kernig's sign[2]

Step 1. The patient is positioned in supine with hip and knee flexed to 90 degrees

Step 2. The knee is then slowly extended by the examiner (Repeat on both legs)

Step 3. Resistance or pain and the inability to extend the patient's knee beyond 135 degrees, because of pain, bilaterally indicates a positive Kernig's sign

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

Sensitivity 5%[3]

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]

  1. ↑ http://www.nlm.nih.gov/medlineplus/ency/imagepages/19077.htm
  2. ↑ Brunner & Suddarth's Textbook of Medical-surgical Nursing, Volume 1. edited by Suzanne C. O'Connell Smeltzer, Brenda G. Bare, Janice L. Hinkle, Kerry H. Cheever. Lippincott Williams & Wilkins, 2010
  3. ↑ 3.0 3.1 3.2 3.3 3.4 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. ↑ 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


Retrieved from "https://www.physio-pedia.com/index.php?title=Kernig%27s_Sign&oldid=246900"