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ULY CLINIC
ULY CLINIC
25 Septemba 2025, 05:11:08
Lasègue’s sign
Lasègue’s sign is a clinical test used to differentiate hip joint disease from sciatica, based on pain elicited during passive leg movements. It helps distinguish musculoskeletal hip pathology from nerve root irritation.
Pathophysiology
Hip joint disease:
Flexion of the hip stretches the joint capsule and periarticular tissues.
Pain arises due to capsular inflammation, arthritis, or intra-articular pathology.
Sciatica (lumbar nerve root irritation):
With the hip flexed, knee extension stretches the sciatic nerve.
Pain indicates nerve root compression or irritation, commonly from disc herniation or spinal stenosis.
Examination Technique
Patient positioning: Place the patient in a supine position.
Hip flexion test:
Flex the hip with the knee bent.
Pain in the hip indicates hip joint disease.
Sciatic nerve stretch test:
With hip still flexed, slowly extend the knee.
Pain radiating down the posterior thigh or leg indicates sciatica.
Documentation: Record side affected, location of pain, and any radiation down the leg.
Clinical Features
Feature | Manifestation |
Hip joint pain | Deep groin or lateral hip pain on passive flexion |
Sciatica pain | Posterior thigh or leg pain on knee extension |
Limitation of movement | Reduced hip flexion or internal rotation |
Associated findings | Muscle spasm, tenderness over hip, sensory deficits (if nerve involved) |
Differential Diagnosis
Condition | Key Feature | Notes |
Hip osteoarthritis | Pain on hip flexion, no radiating leg pain | Chronic, gradual onset |
Femoroacetabular impingement | Groin pain, limited internal rotation | Often in young adults |
Lumbar disc herniation | Pain radiates along sciatic nerve | Positive Lasègue nerve stretch test |
Piriformis syndrome | Buttock pain, possible leg radiation | Sciatic nerve compressed outside spinal canal |
Sacroiliac joint dysfunction | Pain localized to SI joint | Negative nerve stretch test |
Special populations
Elderly:
May have limited hip mobility due to osteoarthritis; nerve stretch may be exaggerated.
Athletes:
More likely to present with labral tears or impingement syndromes, requiring differentiation from lumbar radiculopathy.
Limitations
Pain may be subjective; patient guarding can reduce test accuracy.
False positives can occur in tight hamstrings or acute muscle injury.
Requires gradual movement to avoid provoking severe pain or nerve injury.
Patient counseling
Explain that the test helps identify whether pain originates from the hip joint or the sciatic nerve.
Reassure that findings guide further evaluation, such as imaging (X-ray, MRI) or neurological studies.
Advise patients to avoid sudden movements during testing if pain is present.
Conclusion
Lasègue’s sign is a valuable clinical tool for differentiating hip joint pathology from sciatic nerve irritation. Proper technique and interpretation allow clinicians to guide diagnosis, imaging, and management of musculoskeletal or neurologic causes of lower limb pain.
References
Hoppenfeld S, deBoer P, Buckley R. Physical Examination of the Spine and Extremities. 2nd ed. Philadelphia, PA: Appleton & Lange; 2000.
Deyo RA, Weinstein JN. Low back pain. N Engl J Med. 2001;344:363–370.
Magee DJ. Orthopedic Physical Assessment. 6th ed. Philadelphia, PA: Elsevier; 2021.
Lasègue M. Études cliniques sur la sciatique. Rev Med. 1864;24:385–408.