Spine
Neurological
Evidence: confirmed
Kernig's Sign Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Meningitis or Subarachnoid Hemorrhage.
How to Perform
- Position: Patient supine, hip and knee flexed to 90°.
- Action: Examiner attempts to passively extend the knee.
Interpretation of Results
- Positive Test: Severe stiffness/pain in the hamstrings/neck prevents extension.
Clinical Context & Limitations
The Kernig's Sign should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Spine region, combining the Kernig's Sign with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
