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Straight Leg Raise Test

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Other Names

Straight Leg Raise Test
Illustration of the straight leg raise test[1]
  • SLRT
  • SLR
  • Lasègue sign
  • Lasegue’s sign
  • Straight Leg Test
  • Crossed Straight Leg Raise
  • Bowstring sign
  • Contralateral straight leg raise
  • Braggard sign (Ankle Dorsiflexion)

Purpose

  • Used in patients with lower back pain to evaluate for radicular features
  • First described by Dr. Lazarevic and wrongly attributed to Dr. Lasegue (need citation)

Description

  • Patient is supine
  • Examiner raises leg by passively flexing at the hip 30-70°
  • The knee is kept in extension
  • Can be performed on the contralateral leg as well
  • Positive test
    • Patient experiences pain radiating down leg in similar distribution

Modifications

Crossed or contralateral straight leg raise

    • Performing straight leg raise in uninvolved leg produces symptoms in involved leg
    • Sciatica distribution neuropathic symptoms due to lateral pulling on the dural sac stretching opposite nerve root

Lesegue sign

    • SLRT worse with forced ankle dorsiflexion

Braggard sign (Ankle Dorsiflexion)

    • SLR until symptoms reproduced, then lower leg into nonpainful range
    • Passively dorsiflex ankle
    • Positive test reproduction of sciatica neuropathic symptoms due to increased neural tension
    • Helps differentiate neural tension from hamstring or gastroc muscle tightness

Bowstring sign

    • During SLRT, apply pressure to sciatic or tibial nerve in popliteal fossa
    • Positive test is reproduction of neuropathic symptoms

Pathology


Evidence

Lumbar Radiculopathy

  • Rabin et al[2], Van Der Windt et al[3]
    • Sensitivity 67-95%
    • Specificity: 22-35%

Herniated Nucleus Pulposus (Ipsilateral to leg pain)

  • Deyo et al[4]
    • Patient has pain radiating down ipsilateral leg
    • Sensitivity: 80%
    • Specificity: 40%
    • LR+: 2.0
    • LR=: 0.5

Herniated Nucleus Pulposus (Contralateral to leg pain)

  • Deyo et al[4]
    • Raising contralateral leg causes pain to radiate down ipsilateral leg
    • Sensitivity: 35%
    • Specificity: 90%
    • LR+: 3.5
    • LR=: 0.72

Piriformis Syndrome with Sciatica

  • Martin et al[5]
    • Sensitivity: 0.15
    • Specificity: 0.95
    • LR+: 3.20
    • LR-: 0.90
    • Diagnostic OR: 3.59

See Also


References

  1. de Lucena, Gildásio Lucas, Cristiano dos Santos Gomes, and Ricardo Oliveira Guerra. "Prevalence and associated factors of Osgood-Schlatter syndrome in a population-based sample of Brazilian adolescents." The American journal of sports medicine 39.2 (2011): 415-420.
  2. Rabin A, Gerszten PC, Karausky P, Bunker CH, Potter DM, Welch WC. 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 Jul;88(7):840-3.
  3. Van der Windt DA, Simons E, Riphagen II, et al. Physical examination for lumbar radiculopathy due two disc herniation in patients with low-back pain. Cochrane Database Syst Rev. 2010
  4. 4.0 4.1 Deyo RA, Rainville J, Kent DL. What can the history and physical examination tell us about low back pain? JAMA. 1992;268(6):760–765.
  5. Martin HD, Kivlan BR, Palmer IJ, Martin RL. Diagnostic accuracy of clinical tests for sciatic nerve entrapment in the gluteal region. Knee Surg Sports Traumatol Arthrosc. 2014;22(4):882-888. doi:10.1007/s00167-013-2758-7
Created by:
John Kiel on 14 May 2020 15:35:07
Authors:
Last edited:
25 May 2023 03:49:56
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