CMT Orthopedic Special Tests & Differential Diagnosis 3

Question 1

A positive Spurling's test—cervical compression with lateral flexion and slight extension toward the symptomatic side reproducing arm symptoms—most strongly indicates:

Accepted Answer

Cervical radiculopathy

Answer

Cervicogenic headache

Answer

Thoracic outlet syndrome

Answer

Vertebral artery compromise

Question 2

Vertebral artery screening tests (such as the Sharp-Purser or combined cervical extension-rotation test) are performed PRIMARILY to:

Accepted Answer

Screen for contraindications to cervical high-velocity manipulation

Answer

Quantify cervical range of motion

Answer

Identify cervical disc herniation

Answer

Diagnose upper cervical instability

Question 3

A positive straight leg raise (SLR) that reproduces radicular leg pain between 30° and 60° of hip flexion most strongly indicates:

Accepted Answer

Lumbar nerve root irritation

Answer

Hamstring tightness

Answer

Sacroiliac joint dysfunction

Answer

Piriformis syndrome

Question 4

The Slump test is most useful for differentiating lumbar nerve root compression from:

Accepted Answer

Sacroiliac joint dysfunction or local hip pathology

Answer

Facet joint syndrome

Answer

Thoracic disc herniation

Answer

Lumbar stenosis

Question 5

Waddell's non-organic signs are best described as indicators of:

Accepted Answer

Non-organic or psychosocial contributors to low back pain

Answer

Deliberate malingering or faking symptoms

Answer

Severity of lumbar disc herniation

Answer

Sacroiliac joint instability

Question 6

Kemp's test (lumbar extension combined with ipsilateral lateral flexion and rotation) most likely reproduces symptoms associated with:

Accepted Answer

Lumbar facet joint syndrome

Answer

Lumbar disc herniation

Answer

Piriformis syndrome

Answer

Sacroiliac joint inflammation

Question 7

When a patient demonstrates a positive Kernig's sign—pain and resistance to knee extension when the hip is flexed to 90°—the most appropriate immediate clinical action is to:

Accepted Answer

Refer immediately for medical evaluation due to possible meningeal irritation

Answer

Proceed with lumbar manipulation to relieve nerve tension

Answer

Perform neural mobilization techniques to reduce dural adhesions

Answer

Apply lumbar mechanical traction to decompress the nerve root