Rust’s sign is a cervical spine examination procedure that tests for severe upper cervical instability, rheumatoid arthritis (RA), cervical spine fracture or severe cervical spine sublaxation.  


  1. Patient is seen supporting her neck or head during examination.
  2. The examiner takes note of the patient’s pain response.

Patient presents by holding neck or head.


Positive Rust’s Sign

There is positive Rust’s Sign when the patient presents herself while holding neck or head. This sign indicates possible severe cervical sprain, upper cervical instability, rheumatoid arthritis, cervical spine fracture or severe cervical spine subluxation.

Clinical Notes

Patient’s that show positive for Rust’s Sign should be immediately placed on a neck brace or a cervical collar. This sign should never be overlooked since it presents a serious pathological condition. This test should be immediately followed by diagnostic imaging.