Kemp's test, also known as the quadrant test or extension-rotation test, is a physical examination used to assess for pain related to facet joint problems in the spine, such as osteoarthritis. It's a provocative test, meaning it aims to reproduce the patient's pain to help diagnose the source. The test involves specific movements of the spine, combining extension and rotation. This is performed on either the cervical (neck) or lumbar (lower back) spine.
How Kemp's Test Works
The test involves the patient performing a combined movement:
- Extension: Bending backward.
- Rotation: Twisting the spine to one side.
This combined movement stresses the facet joints on the side towards which the patient rotates. If pain is reproduced in the facet joint, it supports the diagnosis of facet joint pathology as the source of the patient's pain. However, the diagnostic accuracy of Kemp's test is considered poor by some studies.
Uses and Limitations
- Purpose: To diagnose pain originating from facet joints in the cervical or lumbar spine.
- Procedure: The patient performs specific extension and rotation movements while the examiner observes and assesses pain reproduction.
- Limitations: Studies show that Kemp's test has limited diagnostic accuracy. Other tests and imaging may be needed for a definitive diagnosis.
Alternatives and Further Investigations
While Kemp's test is commonly used, its limited diagnostic accuracy often necessitates further investigation, including:
- Other physical examination tests
- Imaging studies (X-rays, CT scans, MRI)
- Further specialist consultations
The literature concerning Kemp's test is limited, with studies indicating poor diagnostic accuracy when compared to other diagnostic methods. Therefore, it is typically used as one piece of information among several clinical findings to aid in the diagnosis of facet joint pain.
