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Cervical Spine Examination
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Sequence
Standing
Look
Sitting
- Look
- Palpation (muscles)
- Gross screening movement
- Sharp Purser
- Neurologic examination
Supine
- Palpation
- Segmental movement
- Flexion rotation test (FRT) - this passive test assesses movement dysfunction at the C1/2 segment. The C1/2 segment comprises around 60% of the total cervical range of motion regardless of age. By maximally flexing the neck, theoretically all structures below C2 are constrained and therefore have limited ability to contribute to rotation. It has been shown to be accurate and reliable. Range of motion reduces with age by about 4-7 degrees per decade.[1]
Side Lying
- Articulation/Segmental mobility
Reliability and Validity
Muscle Tenderness
Site of Tenderness | No or occasional symptoms | Disturbing symptoms |
---|---|---|
Right Trapezius | 0.62 | 0.22 |
Left Trapezius | 0.6 | 0.15 |
Right Levator Scapulae | 0.54 | 0.52 |
Left Levator Scapulae | 0.24 | 0.42 |
Facet Joint Tenderness
The likelihood ratio for tenderness is 3.9[3]
References
- โ Schรคfer, Axel Georg Meender, et al. โUpper Cervical Range of Rotation during the Flexion-Rotation Test Is Age Dependent: An Observational Study.โ Therapeutic Advances in Musculoskeletal Disease, Jan. 2020, Full Text
- โ Levoska et al.. Repeatability of measurement of tenderness in the neck-shoulder region by a dolorimeter and manual palpation. The Clinical journal of pain 1993. 9:229-35. PMID: 8118085. DOI.
- โ Jull et al.. The accuracy of manual diagnosis for cervical zygapophysial joint pain syndromes. The Medical journal of Australia 1988. 148:233-6. PMID: 3343953. DOI.