Spine: crossed straight leg raising: 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: crossed straight leg raising

Sample item

A man with sciatica has pain in his left leg when the examiner raises his right (asymptomatic) leg. What is the significance of this finding?

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

The answer and the reasoning

B. It is highly specific for a herniated lumbar disc

Pain in the symptomatic leg on raising the opposite leg is the crossed straight leg raise or well-leg raising sign. It is uncommon but highly specific for disc herniation, because the healthy leg tugs the dural sleeve and the affected root. A negative test does not exclude a disc.

Option by option

  • A. It indicates hip arthritis

    Hip arthritis restricts rotation and does not give this root tension sign.

  • B. It is highly specific for a herniated lumbar disc (correct)

    Correct. A positive crossed test is specific for disc herniation.

  • C. It indicates hamstring tightness

    Hamstring tightness limits straight leg raising but does not cause pain in the other leg.

  • D. It is highly sensitive and so rules out disc prolapse when absent

    The test has low sensitivity, so a negative result excludes nothing.

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 B, It is highly specific for a herniated lumbar disc. Pain in the symptomatic leg on raising the opposite leg is the crossed straight leg raise or well-leg raising sign.

Why is "It indicates hip arthritis" not the answer?

Hip arthritis restricts rotation and does not give this root tension sign.

Why is "It indicates hamstring tightness" not the answer?

Hamstring tightness limits straight leg raising but does not cause pain in the other leg.

Why is "It is highly sensitive and so rules out disc prolapse when absent" not the answer?

The test has low sensitivity, so a negative result excludes nothing.

What concept does this question test?

It tests Spine: crossed straight leg raising in Orthopaedics. It is uncommon but highly specific for disc herniation, because the healthy leg tugs the dural sleeve and the affected root. A negative test does not exclude a disc.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: crossed straight leg raising?

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.