Pain at lower back and legs when flexed of knee flexes is known as?

Appeared in: PGIMER NO - 2020

Explanation

Kernig's sign is a test for meningeal irritation, a hallmark of meningitis.
The test involves flexing the patient's hip and knee to 90 degrees while they are lying on their back.
A positive sign is indicated by pain and resistance in the lower back or hamstrings when the examiner attempts to straighten the leg.
This pain is caused by the stretching of inflamed meninges (the membranes covering the brain and spinal cord).

Option B: Chadwick sign is related to pregnancy, not neurological assessment. It is a bluish discoloration of the cervix and vagina.
Option C: Hegar's sign is also a sign of pregnancy, specifically the softening of the lower part of the uterus.
Option D: Brudzinski's sign is also a test for meningeal irritation, but the maneuver is different. It involves flexing the neck, not the leg.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Assessment for Meningeal Irritation as background academic context rather than a clinical decision trigger.
Recognizing Kernig's and Brudzinski's signs is a critical nursing skill for the early detection of meningitis, a medical emergency.
Prompt identification allows for immediate diagnostic workup (like a lumbar puncture) and initiation of antibiotic therapy, which can be lifesaving and prevent severe neurological damage.
In pediatric patients, especially infants under 18 months, these signs may be absent or unreliable. Nurses must be aware of other signs like a bulging fontanelle, irritability, or poor feeding.

How to Approach the Question

First, analyze the question to identify the key symptoms and actions: pain in the lower back/legs associated with a specific leg movement (flexion/extension of the knee).
Recognize that the question, despite awkward phrasing, describes a clinical test.
Evaluate the options. Categorize them if possible. Here, two options (Kernig's, Brudzinski's) relate to neurological/meningeal signs, and two (Chadwick's, Hegar's) relate to pregnancy.
Since the symptoms are neurological (pain in back/legs on manipulation), eliminate the pregnancy-related signs (Chadwick's and Hegar's).
Differentiate between the remaining two options. Recall that Kernig's sign involves the leg/knee, while Brudzinski's sign involves the neck.
Match the action described in the question (manipulation of the knee/leg) with the correct sign, which is Kernig's sign.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1568-1570

Practise the full PGIMER NO - 2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.