Execution:
- Patient is in supine position and the examiner stands at the head of the bench
- The examiner places the metacarpophalangeal (MCP) joint of the index finger against the arch of C2 from dorsolaterally. The other hand is placed against the occiput (C0) and C1 with the MCP joint of the index and middle finger from laterally on the opposite side
- The patient’s upper cervical spine is brought in to slight flexion to release the dens of C2 from the anterior arch of the atlas (C1)
- The examiner takes up slack by moving both hands towards each other and then judges movement and end-feel between C0+C1 and C2
- The alar ligament is tested on the side to which the upper hand on C0 and C1 is moving towards
Positive Outcome: Lateral displacement occurs, which is absent in a healthy patient.
|
Study |
Reliability | Sn | Sp | LR+ | LR- |
| Intra-rater к = 0.09-0.67 | NA | NA | NA |
NA |
|
| Cattrysse et al. (1997) | Inter-rater к = -0.64-0.45 | NA | NA | NA |
NA |
| Comment: The study of Cattrysse shows that the reliability of this test is poor. Therefore, this test has a weak clinical value. | |||||
