A treatise on orthopedic surgery . Test for psoas contraction. that rigidity even in the upper dorsal region may be demon-strated by this method, and in testing the lumbar region thethorax should be fixed by the hand. One should then examine for 44 OETEOPEDIC SUBGERY. psoas contraction. The pelvis is pressed firmly against the tablewith one hand, while the leg, held in the line of the body, isgently lifted by the other (Fig. 16). The normal range ofhyperextension at the hip-joint should allow the knee to belifted two or three inches from the table. Restriction of ex-tension of both thighs, ind
A treatise on orthopedic surgery . Test for psoas contraction. that rigidity even in the upper dorsal region may be demon-strated by this method, and in testing the lumbar region thethorax should be fixed by the hand. One should then examine for 44 OETEOPEDIC SUBGERY. psoas contraction. The pelvis is pressed firmly against the tablewith one hand, while the leg, held in the line of the body, isgently lifted by the other (Fig. 16). The normal range ofhyperextension at the hip-joint should allow the knee to belifted two or three inches from the table. Restriction of ex-tension of both thighs, indicating a slight degree of psoas con-traction, is very common in lumbar Potts disease; but when therestriction is marked, and especially if it is unilateral, a deepabscess may be suspected. Such unilateral psoas contractionmay be demonstrated by placing the child on the back, allowing Fig. A method of demonstrating psoas contraction. the limbs to hang over the edge of the table, when the unaffectedthigh will drop below its fellow (Fig. 17). As a rule, flexion of the spine is much more restricted in theearly stage of the disease than is extension; this may be demon-strated by placing the child on its hands and knees, and liftingit from the floor, when the body, instead of bending over thesupporting hands, retains almost its original contour (Fig. 18). As has been stated, even in early cases one may detect oftena slight fulness about the spinous processes or a slight irregu-larity in their line, about which the muscular spasm is mostmarked; this indicates the exact seat of the disease. Deeppressure on the spinous processes may cause discomfort, andsometimes greater elasticity at this point may be in the hands of an expert, it is, however, a test of com- TUBEBCULOUS DISEASE OF THE SPINE. 45 parativelj little value; and again it may be mentioned thatloca
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