Sharp Purser Test: Difference between revisions
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This page is currently under construction by Ben Lippe. Others please do not edit. | This page is currently under construction by Ben Lippe. Others please do not edit. | ||
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== Purpose<br> == | == Purpose<br> == | ||
To detect upper cervical instability. | To detect upper cervical instability. | ||
== Technique<br> == | == Technique<br> == | ||
The patient is seated, with the neck comfortably semi-flexed. The examiner places the palm of one hand on the patient's forehead, and the index finger of the other hand on the tip of the axis. The examiner pushes posteriorly on the patient's forehead. A sliding motion of the head in relation to the axis indicates atlantoaxial instability.<ref name="Uitvlugt">Uitvlugt G, Indenbaum S. Arthritis and Rheumatism. 1988; 31:918-922.</ref> A positive result may also be accompanied by a reduction in symptoms<ref name="Flynn">Flynn TW, Cleland JA, Whitman JM. User's Guide to the Musculoskeletal Examination--Fundamentals for the Evidence-Based Clinician. Evidence in Motion;2008:94.</ref>, a "clunk" sensation, or patient reports of a "click" or "clunk" felt in the roof of their mouth. It is thought that this technique reduces any atlantoax subluxation caused by forward cervical flexion of an unstable spine. | The patient is seated, with the neck comfortably semi-flexed. The examiner places the palm of one hand on the patient's forehead, and the index finger of the other hand on the tip of the axis. The examiner pushes posteriorly on the patient's forehead. A sliding motion of the head in relation to the axis indicates atlantoaxial instability.<ref name="Uitvlugt">Uitvlugt G, Indenbaum S. Arthritis and Rheumatism. 1988; 31:918-922.</ref> A positive result may also be accompanied by a reduction in symptoms<ref name="Flynn">Flynn TW, Cleland JA, Whitman JM. User's Guide to the Musculoskeletal Examination--Fundamentals for the Evidence-Based Clinician. Evidence in Motion;2008:94.</ref>, a "clunk" sensation, or patient reports of a "click" or "clunk" felt in the roof of their mouth. It is thought that this technique reduces any atlantoax subluxation caused by forward cervical flexion of an unstable spine. | ||
== Evidence == | == Evidence == | ||
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add any relevant resources here | add any relevant resources here | ||
== References<br> == | == References<br> == | ||
<references /> | <references /> | ||
[[Category:EIM_Student_Project]] | |||
Revision as of 14:15, 1 July 2009
This page is currently under construction by Ben Lippe. Others please do not edit.
|
Original Editor - Your name will be added here if you created the original content for this page. Lead Editors - Your name will be added here if you are a lead editor on this page. Read more. |
Purpose
[edit | edit source]
To detect upper cervical instability.
Technique
[edit | edit source]
The patient is seated, with the neck comfortably semi-flexed. The examiner places the palm of one hand on the patient's forehead, and the index finger of the other hand on the tip of the axis. The examiner pushes posteriorly on the patient's forehead. A sliding motion of the head in relation to the axis indicates atlantoaxial instability.[1] A positive result may also be accompanied by a reduction in symptoms[2], a "clunk" sensation, or patient reports of a "click" or "clunk" felt in the roof of their mouth. It is thought that this technique reduces any atlantoax subluxation caused by forward cervical flexion of an unstable spine.
Evidence[edit | edit source]
Uitvlugt and Indenbaum[1] compared the Sharp-Purser Test to a gold standard of lateral flexion/extension radiographs in 123 patients with rheumatoid arthritis. They report a sensitivity of 69%, and a specificity of 96%, for laxity >3mm. This yields a positive likelihood ratio of 17.3 and negative likelihood ratio of 0.32.
Resources[edit | edit source]
add any relevant resources here
