Spine: femoral stretch test: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Spine: femoral stretch test

Sample item

A prone patient with anterior thigh pain has the knee flexed and the hip extended by the examiner, which reproduces the pain. Which lesion does this test indicate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Upper lumbar nerve root compression such as L3 or L4

The femoral stretch test tensions the femoral nerve and the L2 to L4 roots, so pain in the anterior thigh points to an upper lumbar disc or root lesion. The sciatic roots L5 and S1 are tested by straight leg raising. It is the counterpart of the straight leg raise for higher lumbar levels.

Option by option

  • A. Upper lumbar nerve root compression such as L3 or L4 (correct)

    Correct. The test stretches the femoral nerve and upper lumbar roots.

  • B. S1 nerve root compression

    S1 involvement is shown by the straight leg raise and ankle jerk loss.

  • C. Piriformis syndrome

    Piriformis syndrome is tested by hip flexion, adduction and internal rotation.

  • D. Sacroiliac joint arthritis

    Sacroiliac arthritis is tested by pelvic compression and Patrick tests.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Upper lumbar nerve root compression such as L3 or L4. The femoral stretch test tensions the femoral nerve and the L2 to L4 roots, so pain in the anterior thigh points to an upper lumbar disc or root lesion.

Why is "S1 nerve root compression" not the answer?

S1 involvement is shown by the straight leg raise and ankle jerk loss.

Why is "Piriformis syndrome" not the answer?

Piriformis syndrome is tested by hip flexion, adduction and internal rotation.

Why is "Sacroiliac joint arthritis" not the answer?

Sacroiliac arthritis is tested by pelvic compression and Patrick tests.

What concept does this question test?

It tests Spine: femoral stretch test in Orthopaedics. The sciatic roots L5 and S1 are tested by straight leg raising. It is the counterpart of the straight leg raise for higher lumbar levels.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Spine: femoral stretch test?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.