Spine Cervical Spine Evidence: confirmed

Lhermitte Sign Special Test

Orthopedic Physical Examination & Clinical Assessment Guide

Lhermitte Sign Orthopedic Special Test

What is it used for?

  • Screening for Cervical Myelopathy (spinal cord compression), Multiple Sclerosis, or severe Stenosis.

How to Perform

  • Position: Patient sits on the table with legs extended (long sitting).
  • Action: Examiner passively flexes the patient's neck forward (chin to chest).

Interpretation of Results

  • Positive Test: A sudden "electric shock" sensation shooting down the spine and into the arms or legs.

Diagnostic Accuracy

  • Sensitivity: 3-17%
  • Specificity: 97%

Clinical Context & Limitations

The Lhermitte 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 Lhermitte Sign with complementary examination tests significantly improves overall diagnostic confidence.

References

  • Clinical Tests for the Musculoskeletal System 3rd Ed. Book

Further Clinical Exploration

Spurling's Test
Spine Examination

Spurling's Test

Distraction Test
Spine Examination

Distraction Test

Lasegue Test (Straight Leg Raise)
Spine Examination

Lasegue Test (Straight Leg Raise)

Crossed Over Lasegue (Well Leg Raise)
Spine Examination

Crossed Over Lasegue (Well Leg Raise)