Straight leg raise

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The Straight leg raise, also called Lasègue's sign, Lasègue test or Lazarević's sign, is a test done during the physical examination to determine whether a patient with low back pain has an underlying herniated disk, mostly located at L5 (fifth lumbar spinal nerve), S1 (the first sacral spinal nerve) or S2 (the second sacral spinal nerve).

Technique

With the patient lying down on his/her back on an examination table/or exam floor, the examiner lifts the patient's leg while the knee is straight.

A variation is to lift the leg while the patient is sitting.[1] However, this reduces the sensitivity of the test.[2]

Interpretation

"The straight leg raise test is positive if pain in the sciatic distribution is reproduced between 30 and 70 degrees passive flexion of the straight leg." [3]

A meta-analysis reported the accuracy as[4]:

If raising the opposite leg causes pain (cross straight leg raising):

  • sensitivity 29%
  • specificity 88%


Lasègue's sign

Lasègue's sign was named after Charles Lasègue (1816-1883).[5] In 1864, Lasègue described the signs of developing low back pain while straightening the knee when the leg has already been lifted. In 1880, Serbian doctor Laza Lazarević described the straight leg raise test as it is used today, so the sign is often named Lazarević's sign in Serbia and some other countries.[6]

References

  1. Waddell G, McCulloch JA, Kummel E, Venner RM (1980). "Nonorganic physical signs in low-back pain". Spine. 5 (2): 117–25. doi:10.1097/00007632-198003000-00005. PMID 6446157. 
  2. Rabin A, Gerszten PC, Karausky P, Bunker CH, Potter DM, Welch WC (2007). "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". Archives of physical medicine and rehabilitation. 88 (7): 840–3. doi:10.1016/j.apmr.2007.04.016. PMID 17601462. 
  3. Speed C (2004). "Low back pain". BMJ. 328 (7448): 1119–21. doi:10.1136/bmj.328.7448.1119. PMC 406328Freely accessible. PMID 15130982. 
  4. Devillé WL, van der Windt DA, Dzaferagić A, Bezemer PD, Bouter LM (2000). "The test of Lasègue: systematic review of the accuracy in diagnosing herniated discs". Spine. 25 (9): 1140–7. doi:10.1097/00007632-200005010-00016. PMID 10788860. 
  5. [1]
  6. Lazarevićev znak (Croatian)
de:Lasègue-Zeichen

fr:Signe de Lasègue hr:Lasegueov znak it:Segno di Lasègue nl:Proef van Lasègue pl:Objaw Lasègue'a