Straight Leg Raise Test
This neural tension test can be used to rule out neural tissue involvement as a result of a space occupying lesion, often a lumbar disc herniation.
When performing the straight leg raise test the patient is positioned supine in the absence of pillows. The clinician lifts the patient's symptomatic leg by the posterior ankle while keeping the knee in a fully extended position. The clinican continues to lift the patient's leg by flexing at the hip until pain is illicited or end range is reached. Neurologic pain which is reproduced in the leg and low back between 30-70 degrees of hip flexion is a positive result of lumbar disc herniation at the L4-S1 nerve roots. In order to make this test more specific, the ankle can be dorsiflexed and the cervical spine flexed. This increases the stretching of the nerve root and dura.
Pain at less than 30 degrees of hip flexion might indicate acute spondyloithesis, gluteal abscess, disc protrusion or extrusion, tumor of the buttock, an acute dural inflammation, a malingering patient, or the sign of the buttock. Pain at greater than 70 degrees of hip flexion might indicate tightness of the hamstrings, gluteus maximus, hip capsule or a pathology of the hip or sacroiliac joints.
A highly specific test that can aid in the diagnosis of a herniated nucleus pulposus is the crossed straight leg raise test.
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- ↑ 1.0 1.1 Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
- ↑ Online video, http://www.youtube.com/watch?v=vWrBNK94XO8&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;feature=related, last accessed 06/01/09.
- ↑ Rabin A, Gerszten PC, Karausky P, et al. The Sensitivity of the Seated Straight-Leg Raise Test Compared With the Supine Straight-Leg Raise Test in Patients Presenting With Magnetic Resonance Imaging Evidence of Lumbar Nerve Root Compression. Arch Phys Med Rehabil. 2007;(88):840-843.
- ↑ Deville WL, van der Windt DA, Dzaferagic A, et al. The test of Lasegue: systematic review of the accuracy in diagnosing herniated discs. Spine 2000;25:1140-7.
Learn about the knee in this month's members learn topic with book chapters including D. Magee 2014: Orthopedic Physical Assessment