The Nachlas test is a specific orthopedic maneuver used to assess for pain and dysfunction, particularly in the sacroiliac joint and lumbosacral region. It involves flexing the patient's knee and applying pressure to the ankle, moving the heel towards the buttock to test the affected area.
Understanding the Nachlas Test Procedure
Here's a breakdown of how the Nachlas test is performed, as described in the provided reference:
- Patient Positioning: The patient typically lies prone (face down) on an examination table.
- Knee Flexion: The examiner flexes the patient's knee to a 90-degree angle.
- Ankle Pressure: The examiner applies pressure to the front of the patient's ankle.
- Heel Movement: While maintaining pressure, the examiner slowly directs the patient's heel toward their buttock on the same side (ipsilateral).
- Ilium Stabilization: The examiner's other hand should stabilize the contralateral ilium (the hip bone on the opposite side).
What Does a Positive Nachlas Test Indicate?
A positive Nachlas test occurs when the patient experiences pain or discomfort during the maneuver. This can suggest several potential issues:
- Sacroiliac Joint Dysfunction: Pain in the sacroiliac joint area during the test can indicate a problem with the joint itself.
- Lumbosacral Pathology: Pain in the lower back may point to issues in the lumbosacral region, such as muscle strain or ligament sprain.
- Hip Issues: In some instances, pain might be referred from the hip joint itself.
Why is the Nachlas Test Useful?
The Nachlas test is a valuable tool for clinical examination because it:
- Identifies Potential Problems: Helps clinicians pinpoint the source of a patient's back or hip pain.
- Simple to Perform: It's a non-invasive procedure that doesn't require specialized equipment.
- Assists in Differential Diagnosis: Helps differentiate between various conditions, contributing to a more accurate diagnosis.
Practical Insights
- Pain Location Matters: The location of the patient's pain during the test provides clues about the involved structures.
- Compare Sides: It's important to perform the test on both sides to compare the patient's responses and identify any asymmetries.
- Additional Tests: The Nachlas test is often used in conjunction with other tests to confirm a diagnosis.
Summary
Test Name | Description |
---|---|
Nachlas Test | Involves flexing the knee to 90 degrees, applying pressure to the ankle, and moving the heel towards the same-side buttock while stabilizing the opposite ilium. |