straight leg raising test - DNB Orthopaedics MS Orthopedics MRCS Exam GUIDE -

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Friday 13 April 2018

straight leg raising test

straight leg raising test  SLRT

  • slowly raise the leg -knee extended – till patient reports pain
  • intense pain in sacrum and leg – nerve root irritation (disk extrusion or tumor) – extra cranial compression of nerve root
  • positive sign when shooting pain into leg along the course corresponding to motor or sensory dermatome of affected nerve root
  • angle at which pain starts in degrees measured – indicates severity of nerve root irritation
  • patient attempts to avoid pain by raising the pelvis on the side examined
  • sacral or lumbar pain, increases slowly as leg raised or pain in posterior thigh in -pseudo radicular pain (pseudo Lasegue sign) [against true sciatica]
    • degenerative joint disease ( facet syndrome)
    • pelvic ligament irritation ( tendinitis)
    • increased tension in hamstring
  • Image result for straight leg raising test
LASEGUE SIGN (with patient seated)
  • sitting at edge of examining table – flex hip with extended knee
  • tries to avoid pain by leaning forward – using arms for support – FLIP or tripod sign
  • non painful leg raise – knee extended
  • movement of lifting the other leg referred to affected segment – cause sciatica at affected leg – in case of disk extrusion with nerve root irritation
  • for differentiating genuine from pseudo Lasegue sign
  • supine – heel in one hand – other hand over anterior knee – leg raised with knee extended - at onset of pain stop raising – lowered to the point of painlessness – passively dorsiflex into extreme position – typical pain elicited – d/t stretching of sciatic nerve
  • positive Bragrad – nerve root compression – L4S1
  • sensation of tension in calf – thrombosis – thrombophlebitis – contracture of gastrocnemius
  • usually negative in malingerers
  • prone – passively raises leg – with flexion at knee
  • hyper extension hip with knee flexed – traction of femoral nerve
  • u/l or b/l radicular pain in sacrum or anterior thigh or leg – L3- L4 nerve root irritation
Stages of SLRT

  • negative
  • small protrusion
    • painful not limiting motion
    • painful arc
  • painful – limited – no neurological deficit
  • painful – limited – neurological deficit
  • no motion with neurological deficit
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