Sensitivity of Laségue Sign and Slump Test in Hernia and Disc Bulging Diagnoses Compared with Magnetic Resonance Imaging

Miranda, Isabel Hahn; Raymundo, José Luiz Pozo; Klein, Kevin Maahs

doi:10.1055/s-0040-1722590

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Sumário

Original Article • Rev. bras. ortop. 56 (06) • Nov-Dec 2021 • https://doi.org/10.1055/s-0040-1722590 copy

Sensitivity of Laségue Sign and Slump Test in Hernia and Disc Bulging Diagnoses Compared with Magnetic Resonance Imaging^* * Study carried out by the Orthopedics Group of the Universidade Federal de Pelotas (UFPel) at the Clinic of Orthopedics and Traumatology Dr. José Raymundo, Pelotas, RS, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To show the accuracy of the most used maneuvers in the clinical diagnosis of lumbosciatalgia, the slump test and the Laségue sign.

Methods

In order to perform the present study, 101 patients with magnetic resonance imaging (MRI) discopathy (gold standard) were selected and had their medical records reviewed to identify which had the positive maneuvers on the initial physical examination.

Results

The sensitivity found for the slump test and the Laségue sign in the diagnosis of disc herniation was 55.3% and 18.1%, respectively. Nonetheless, when they were compared with each other for the diagnosis of disc bulging, the sensitivity obtained was of 85.7% for the slump test and of 28.6% for the Laségue sign.

Conclusion

Comparing both clinical exams with MRI, it was found that the slump test presents superior sensitivity compared with the Laségue sign for both the diagnosis of hernia and disc bulging, and should be more present in clinical practice.

Keywords
sensitivity and specificity; lower back pain; disc hernia; radiculopathy

Variable	General (n = 101)	Female (n = 62)	Male (n = 39)
Age (years old)	53.2 ± 15.7 (18-86)	53.8 ± 16.3 (18-84)	52.1 ± 14.9 (18-89)
Discopathy
- Hernia	94 (93.1%)	56 (90.3%)	38 (97.4%)
- Bulging	7 (6.9%)	6 (9.7%)	1 (2.6%)

	Maneuver	Side	Cases with alteration	Sensitivity	95%CI
Total (n = 94)	Slump	Right	34	36.2%	26.5%-45.9%
		Left	35	37.2%	27.5%-47%
		Bilateral	17	18.1%	10.3%-25.9%
		Right and/or left	52	55.3%	45.3%-65.4%
	Lasègue	Right	11	11.7%	5.2%-18.2%
		Left	9	9.6%	3.6%-15.5%
		Bilateral	3	3.2%	0%-6.7%
		Right and/or left	17	18.1%	10.3%-25.9%
Female (n = 56)	Slump	Right	18	32.1%	19.9%-44.4%
		Left	18	32.1%	19.9%-44.4%
		Bilateral	9	16.1%	6.5%-25.7%
		Right and/or left	27	48.2%	35.1%-61.3%
	Lasègue	Right	6	10.7%	2.6%-18.8%
		Left	5	8.9%	1.5%-16.4%
		Bilateral	2	3.6%	0%-8.4%
		Right and/or left	9	16.1%	6.5%-25.7%
Male (n = 38)	Slump	Right	16	42.1%	26.4%-57.8%
		Left	17	44.7%	28.9%-60.5%
		Bilateral	8	21.1%	8.1%-34%
		Right and/or left	25	65.8%	50.7%-80.9%
	Lasègue	Right	5	13.2%	2.4%-23.9%
		Left	4	10.5%	0.8%-20.3%
		Bilateral	1	2.6%	0%-7.7%
		Right and/or left	8	21.1%	8.1%-34%

	Maneuver	Side	Cases with alteration	Sensitivity
Total (n = 7)	Slump	Right	6	85.7%
		Left	1	14.3%
		Bilateral	1	14.3%
		Right and/or left	6	85.7%
	Lasègue	Right	2	28.6%
		Left	0	0%
		Bilateral	0	0%
		Right and/or left	2	28.6%
Female (n = 6)	Slump	Right	6	100%
		Left	1	16.7%
		Bilateral	1	16.7%
		Right and/or left	6	100%
	Lasègue	Right	2	33.3%
	Lasègue	Left	0	0%
		Bilateral	0	0%
		Right and/or left	2	33.3%
Male (n =1)	Slump	Right	0
		Left	0
		Bilateral	0
		Right and/or left	0
	Lasègue	Right	0
		Left	0
		Bilateral	0
		Right and/or left	0

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[1] *
Study carried out by the Orthopedics Group of the Universidade Federal de Pelotas (UFPel) at the Clinic of Orthopedics and Traumatology Dr. José Raymundo, Pelotas, RS, Brazil.