31/12/2019 - 13:19
It is so important to perform the passive hip flexion immediately after the straight leg raise during the lumbar functional examination, otherwise we cannot detect the "Sign of the buttock", which could be an important red flag.
The sign of the buttock is part of a combination of findings which indicates serious gluteal pathology. It is considered being a red flag.
The patient suffers from gluteal pain, which may or may not spread down the leg.We perform the standard functional examination of the lumbar spine :
Because of the positive hip signs, the complete hip examination should be included. Some resisted hip tests may prove positive.
A complementary examination is called for.
This clearly illustrates the importance of performing the passive hip tests immediately after having tested the straight leg raise in the lumbar examination. Hip tests are not just hip tests, but enable us to discover serious local pathology in the buttock.
Keep in mind that the presence of one red flag only has limited value ; we have to be aware of a combination of red flags.