Nachlas’ Test

Indications

Nachlas’ test is a useful examination to differentiate between sacroiliac, lumbar spine ligamentous sprain and femoral nerve pathology.


Procedure

  1. Patient prone with knee flexed 90°
  2. Examiner flexes knee in attempt to touch patient’s heel to ipsilateral buttock.
Nachlas' Orthopaedic test.

Examiner flexes patients knee in attempt to touch patient’s heel to ipsilateral buttock.

Interpretation

Nachlas’ test can be used to differentiate between sacroiliac, lumbar spine, knee injury, as well as femoral nerve pathology.

Positive Nachlas’ Test

There are three interpretation for a positive Nachlas’ Test.

  1. Local lower back pain: Local lumbar spine or sacroiliac joint injury.
  2. Local knee pain: Knee injury (ligamentous, meniscal, tendon injury).
  3. Radicular pain: Anterior thigh radicular symptoms can be caused by femoral nerve pathology.

Clinical Notes

  1. Motion of test stretches the femoral nerve & may cause radicular symptoms.
  2. Patient with quadriceps contracture will show decreased range of motion.