Neuro – 1. Diadochokinesis
 

ADAM SIGN (POSITIONS)

  1. POSITIVE: A “c” or “s” shaped scoliosis is observed to straighten.
  2. POSITIVE: A “c” or “s” shaped scoliosis does not straighten.
  1. INDICATES: Negative: evidence of a functional scoliosis, trauma or subluxation.
  2. INDICATES: Positive: evidence of a pathologic or structural scoliosis.

Patient Instructions: Patient standing, with examiner standing behind patient, examiner looks for evidence of scoliosis. Examiner instructs the patient to bend forward at the waist. Examiner observes for evidence of a change in the scoliosis.

Clinical Notes: Look for rib humping, muscular imbalance, and asymmetry in hand length as findings.

Do’s and Don’ts: Do look and palpate if necessary at the spine before during and after. DO NOT let the patient bend forward if wearing a gown that is not tied up. Usually they have a male with no shirt on. DO NOT touch the patient in any way other than her spine. Explain you will be on her back looking for any deviation.

Neuro – 2. Supination Test
 

SCHEPELMANN SIGN

POSITIVE: Pain on the concave or convex side.

INDICATES: Pain on the concave side indicates intercostal neuritis. Pain on the convex side indicates fibrous inflammation of the pleura.


Patient Instructions: Patient seated arms fully abducted and raised over head, examiner instructs patient to laterally flex thoracic spine to the left side and then to the right side.

Clinical Notes: Possible intercostal myofasciitis as ddx from pleuritis or neuritis.

Do’s and Don’ts: Make sure the pelvis remains on the table if seated.

Course Information

Course Instructor

CBR2021 CBR2021 Author