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Straight Leg Raise Test
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Contents
Other Names
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
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
- ↑ 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.
- ↑ 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.
- ↑ 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
- ↑ 4.0 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.
- ↑ 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