alar, alar ligament, anatomy, C2, cervical, ligament, ligament integrity, ligament laxity, ortho, sidebending, special test, spinous process, upper cervical

Purpose

A test used to assess the integrity of the alar ligament.

Technique

Patient is positioned seated.

Clinician palpates the C2 spinous process with his hand closest to the patient.

Clinician uses his other hand to sidebend the patient’s head while feeling the movement of the spinous process with his palpation hand.

Clinician sidebends patient to both sides.

When sidebending R, the Clinician expects to feel the spinous process immediately rotate into the L side of his palpation finger as the spinous process goes into R rotation.

When sidebending L, the Clinician expects to feel the spinous process immediately rotate into the R side of his palpation finger as the spinous process goes into L rotation.

Positive

Spinous process does not immediately move in expected direction.

Interpretation

A positive test indicates laxity of the contralateral alar ligament.

References

1. Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York, NY: The McGraw-Hill Companies, Inc.

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