Lasègue sign

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The Lasègue sign (also Lasègue test , Lazarević sign or Lasègue-Lazarević sign ) describes a possible stretch pain of the sciatic nerve and / or the spinal nerve roots in the lumbar and sacral segments of the spinal cord as part of an examination method from orthopedics , neurology and rheumatology , the Lasègue-Lazarević test.

The names of the sign go back to the French internist Ernest-Charles Lasègue (1816–1883) and the Serbian neurologist Laza Kuzman Lazarević (1851–1890).

execution

Performing the Lasègue test: Slow, careful lifting of the extended leg by the examiner (stop if pain occurs)

The patient lies flat on his back. The stretched leg is passively bent in the hip joint by up to 70 °. If pain is reported , flexion will not continue until it is physiologically possible. If there is pain in the leg up to an angle of about 45 degrees, which is sharp, shoot into the leg from the back and radiate below the knee, the test is positive and is known as the Lasègue sign. The stretching of the sciatic nerve (sciatic nerve) is seen as the cause of pain. If pain is indicated at an angle of 60–70 °, it is referred to as a pseudolasègue or a pseudopositive Lasègue sign; it can also be a stretching pain of the hamstring muscles .

Pure pain of a non-shooting character in the leg or thigh is to be rated as muscle stretching pain. The possible Lasègue sign can be intensified by simultaneous internal rotation of the leg; also by dorsiflexion of the foot (so-called Bragard's sign ). The angle at which the pain starts is noted. The pain generally results in reflex resistance to movement. The nerve roots of segments L4 / L5 or L5 / S1 are compressed.

The Lasègue test can result in positive results in sciatica , a herniated disc or meningeal irritation such as meningitis or subarachnoid hemorrhage .

The reverse Lasègue sign (reverse Lasègue) is the triggering of pain with flexion in the knee joint with the hip joint extended (the patient lies flat on the stomach) as a stretch sign of the femoral nerve (compression of the L3 / L4 nerve roots).

See also

Brudzinski signs , Kernig signs , Mennell signs , Bragard signs

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