Nachlas’ Test

Physical Assessment | Spinal Orthopaedics

Introduction

Goldthwait’s Test is an orthopaedic test used to differentiate between Lumbar spine pathology and Sacroiliac (SI) joint pathology.


Procedure

  1. Patient supine, examiner slowly raises the patient’s affected leg with one hand while palpation motion at the lumbar spine with the other hand.
  2. Test is then repeated on the opposite side.
Goldthwait orthopaedic test

Examiner slowly raises the patient’s affected leg with one hand while palpating motion at the lumbar spine with the other hand

Interpretation

Goldthwait’s test can be used to differentiate between lumbar spine and sacroiliac joint pathology.

Positive Goldthwait’s’ Test

There are two interpretation for a positive Goldthwait’s Test.

  1. Pain before lumbar spine motion is felt: Sacroiliac joint pathology (ligamentous sprain, arthritis).
  2. Pain beginning when lumbar spine motion is felt: Lumbosacral pathology (sprain/strain, possible disc syndrome).

Clinical Notes

Sacroiliac joint involvement should be suspected if the unaffected leg can be elevated higher than the affected leg.