Kernig's Sign
Original Editor Oyemi Sillo
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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
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]
- ↑ http://www.nlm.nih.gov/medlineplus/ency/imagepages/19077.htm
- ↑ 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
- ↑ 3.0 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
- ↑ 4.0 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
