Which clinical scenario would most support ordering a straight leg raising test to evaluate possible disc herniation?

Which clinical scenario would most support ordering a straight leg raising test to evaluate possible disc herniation?

• A. Suspected acute coronary syndrome.
• B. Chronic knee osteoarthritis.
• C. Acute radicular symptoms with low back pain.
• D. Fractured wrist.

Answer: (C)

The straight leg raise tests for nerve root irritation from a lumbar disc herniation. When someone has acute low back pain with symptoms radiating down the leg (radicular symptoms), lifting the straight leg stretches the sciatic nerve and can reproduce the leg pain if a disc is compressing a lumbar nerve root. A positive test—pain or paresthesias radiating below the knee with the leg raised—supports disc herniation as part of the differential. It's not helpful for conditions like suspected acute coronary syndrome, chronic knee osteoarthritis, or a wrist fracture, which don’t involve lumbar nerve root compression.

The straight leg raise tests for nerve root irritation from a lumbar disc herniation. When someone has acute low back pain with symptoms radiating down the leg (radicular symptoms), lifting the straight leg stretches the sciatic nerve and can reproduce the leg pain if a disc is compressing a lumbar nerve root. A positive test—pain or paresthesias radiating below the knee with the leg raised—supports disc herniation as part of the differential. It's not helpful for conditions like suspected acute coronary syndrome, chronic knee osteoarthritis, or a wrist fracture, which don’t involve lumbar nerve root compression.