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Sharp Purser Test

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Other Names

  • Sharp-Purser Test
  • Sharp Purser Test


The Sharp-Purser Test[1]


  • The patient is is in the seated position
  • The head is slightly flexed
  • Examiner places one hand on the forehead, other hand is placed on spinous process of C2
  • A posteriorly directed force is applied to the forehead while the other hand stabilizes the SP of C2
  • There should be a clear end point
  • Positive Test:
    • Sliding movement
    • Decrease in symptoms
    • "Clunk"



Atlantoaxial Instability

  • Uitvlugt et al[2]
    • Sensitivity: 69%
    • Specificity: 96%
    • LR-: 0.32
    • LR+: 17.3

See Also


  1. Mintken, Paul E., Lisa Metrick, and Timothy Flynn. "Upper cervical ligament testing in a patient with os odontoideum presenting with headaches." journal of orthopaedic & sports physical therapy 38.8 (2008): 465-475.
  2. Uitvlugt G, Indenbaum S. Clinical assessment of atlantoaxial instability using the Sharp-Purser test. Arthritis Rheum. 1988 Jul;31(7):918-22. PubMed PMID: 3395385.
Created by:
John Kiel on 10 August 2019 01:50:07
Last edited:
21 May 2023 15:39:29