Brudzinski’s Sign

Original Editor ­ Oyemi Sillo

Top Contributors - Sweta Christian, Oyemi Sillo and Evan Thomas ­

Description

Brudzinski's sign is one of the physically demonstrable symptoms of meningitis. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed.[1]

Purpose

Indicates meningeal irritation.[2]

Technique

To elicit the Kernig's sign, the patient is kept in supine position, hip and knee are flexed to a right angle, and then the knee is slowly extended by the examiner. The appearance of resistance or pain during extension of the patient's knees beyond 135 degrees constitutes a positive Kernig's sign

• Patient lies supine
• Flex neck, bringing chin to chest
• Positive sign is involuntary flexing of hips.

Evidence[3]

Sensitivity: 5; Specificity: 95; Positive likelihood ratio: 0.97; Negative likelihood ratio: 1.0

See test diagnostics page for an explanation of statistics.


References

  1. http://www.nlm.nih.gov/medlineplus/ency/imagepages/19069.htm
  2. Introduction to Emergency Medicine edited by Elizabeth Mitchell, Ron Medzon. Lippincott Williams & Wilkins, 2005
  3. Karen E. Thomas, Rodrigo Hasbun, James Jekel, Vincent J. Quagliarello. The Diagnostic Accuracy of Kernig's Sign, Brudzinski's Sign, and Nuchal Rigidity in Adults with Suspected Meningitis. Clin Infect Dis. (2002) 35 (1): 46-52.
[1]
  1. Manmohan Mehndiratta, Rajeev Nayak, Hitesh Garg, Munish Kumar, and Sanjay Pandey (2012). Appraisal of Kernig's and Brudzinski's sign in meningitis.Ann Indian Acad Neurol. 2012 Oct-Dec; 15(4): 287–288. doi: 10.4103/0972-2327.104337