Tests and Diagnosis of sciatica
PHYSICAL EXAMINATION
Tenderness
• Mid reason for line joining the PSIS & Ischial tuberosity.
• Half way between your GT & Ischial tuberosity
• Along the back of thigh
Nerve stretch tests
• Used to detect nerve root irritation, usually as a result of prolapsed lumbar disc
Straight Leg Raising
• Lie the individual on their back with knee extended
• Elevate the lower limb (Normal 80-90degrees of flexion isusually possible)
• Repeat and match up against other leg
• A positive test would show pain within the sciatic nerve between 60-70 degrees flexion
• (Felt in the posterior surface of the buttocks towards the foot)
• Sensitivity of 91%
• Specificity of 26%
Lasègue’s test
• •Lasègue’s test is performed whenthe leg is elevate using the knee relaxed
• Flexion from the knee
• would hence stretch
• the Sciatic nerve and
• if pain exists,
• Sciatica may be present
Bragard test
• Pain is gone through by dorsi flexing the foot
• Sensitivity of 91%
• Specificity of 26%
Cross Leg Raising
• Cross leg raising happens when the lifting from the healthy leg while using SLR method is painful in the affected leg.
• Sensitivity of 33%
• Specificity of 98%
• Patients which have a disc prolapse and nerve root irritation will probably have a positive SLR but so might be a significant number of patients who don’t have this problem
• However a positive crossed SLR test argues for any disc prolapse and nerve irritation
Others
• •Other physical examination findings for example muscle weakness, sensation and reflexes ought to be used in a neurological study of the bac
MOTOR EXAMINATION
• Myotomes testing
SENSORY EXAMINATION
• Dermatomes testing
IMAGING TESTS
In case your pain lasts more than four weeks or is severely, or you have another serious condition for example cancer, you may have a number of imaging tests to assist identity why the sciatic nerve is compressed and also to rule out other causes for the symptoms.
These tests include:
• Spinal X-ray. Ordinary X-rays can't detect herniated disk problems or nerve damage. A spinal X-ray might help pinpoint the cause of sciatica.
• Magnetic resonance imaging (MRI). This might be the most sensitive test for assessing sciatica. Instead of X-rays, MRI uses a powerful magnet and radio waves to create cross-sectional images of your back. Most MRI machines are large, tube-shaped magnets. Throughout the test, you lie on the movable table within the MRI machine.
• Computerized tomography (CT) scan. This test utilizes a narrow beam of radiation to create detailed, cross-sectional images of the body. When CT is used to image the spine, you might have a contrast dye injected to your spinal canal prior to the X-rays are taken - a process called a CT myelogram. The dye then circulates around your spinal-cord and spinal nerves, which appear white around the scan.
Tenderness
• Mid reason for line joining the PSIS & Ischial tuberosity.
• Half way between your GT & Ischial tuberosity
• Along the back of thigh
Nerve stretch tests
• Used to detect nerve root irritation, usually as a result of prolapsed lumbar disc
Straight Leg Raising
• Lie the individual on their back with knee extended
• Elevate the lower limb (Normal 80-90degrees of flexion isusually possible)
• Repeat and match up against other leg
• A positive test would show pain within the sciatic nerve between 60-70 degrees flexion
• (Felt in the posterior surface of the buttocks towards the foot)
• Sensitivity of 91%
• Specificity of 26%
Lasègue’s test
• •Lasègue’s test is performed whenthe leg is elevate using the knee relaxed
• Flexion from the knee
• would hence stretch
• the Sciatic nerve and
• if pain exists,
• Sciatica may be present
Bragard test
• Pain is gone through by dorsi flexing the foot
• Sensitivity of 91%
• Specificity of 26%
Cross Leg Raising
• Cross leg raising happens when the lifting from the healthy leg while using SLR method is painful in the affected leg.
• Sensitivity of 33%
• Specificity of 98%
• Patients which have a disc prolapse and nerve root irritation will probably have a positive SLR but so might be a significant number of patients who don’t have this problem
• However a positive crossed SLR test argues for any disc prolapse and nerve irritation
Others
• •Other physical examination findings for example muscle weakness, sensation and reflexes ought to be used in a neurological study of the bac
MOTOR EXAMINATION
• Myotomes testing
SENSORY EXAMINATION
• Dermatomes testing
IMAGING TESTS
In case your pain lasts more than four weeks or is severely, or you have another serious condition for example cancer, you may have a number of imaging tests to assist identity why the sciatic nerve is compressed and also to rule out other causes for the symptoms.
These tests include:
• Spinal X-ray. Ordinary X-rays can't detect herniated disk problems or nerve damage. A spinal X-ray might help pinpoint the cause of sciatica.
• Magnetic resonance imaging (MRI). This might be the most sensitive test for assessing sciatica. Instead of X-rays, MRI uses a powerful magnet and radio waves to create cross-sectional images of your back. Most MRI machines are large, tube-shaped magnets. Throughout the test, you lie on the movable table within the MRI machine.
• Computerized tomography (CT) scan. This test utilizes a narrow beam of radiation to create detailed, cross-sectional images of the body. When CT is used to image the spine, you might have a contrast dye injected to your spinal canal prior to the X-rays are taken - a process called a CT myelogram. The dye then circulates around your spinal-cord and spinal nerves, which appear white around the scan.
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awesome!
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