Crossed Over Lasegue (Well Leg Raise) Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing a Large Central Disc Herniation.
How to Perform
- Position: Patient lies supine.
- Action: Perform a Straight Leg Raise on the unaffected (pain-free) leg.
Interpretation of Results
- Positive Test: Pain shoots down the affected (bad) leg even though it is not moving.
- Why: Pulling the nerve roots on the good side drags the dural sac, which indirectly pulls on the nerve roots of the bad side. This is highly specific for a herniated disc.
Diagnostic Accuracy
- High Specificity (>88%)
Clinical Context & Limitations
The Crossed Over Lasegue (Well Leg Raise) should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Spine region, combining the Crossed Over Lasegue (Well Leg Raise) with complementary examination tests significantly improves overall diagnostic confidence.
References
- Clinical Tests for the Musculoskeletal System.
