Derifield Leg Check Cervical Portion / Spinal Listing with Schematics

Purpose of Cervical Leg checks

1.) to help identify potential subluxation

2.) does not give restricted motion

3.) use other tools → instrumentation, static and motion palpation

4.) also useful to know if the patient has an anatomical short leg (AD)

Patient Placement

1.) best to have the patient lay prone on a hy-lo table

2.) standing neutral initially and then to a neutral prone position

3.) make sure that the leg relaxer bar is up

Visulaization of Footwear

1.) preference to visualize where the heel of the sole meets the shoe

2.) alternate would be the inferior malleoli (not the most accurate)

Instructions for patient placement

1.) place patient prone on appropriate table

2.) apply pressure cephalically to ensure the seat of the shoe is flushed against the patient’s foot, take out any inversion or eversion of the feet

3.) identify the patient’s short leg

4.) instruct the patient to turn their head to the right or left

5.) apply caudal pressure on the heels of the shoes again

6.) note if the short leg became longer or stayed the same

Instructions Continued

1.) cervical syndrome: the side that the patient’s head was turned towards that caused the leg to go even/long is recorded (RCS, LCS, BCS)

2.) with the patient’s head turned, palpate down the cervical spin for taut/tender fibers, prominent and nodular swelling (patient’s head turned to the right, palpate the left)

3.) taut, tender and prominent fibers suggest posterior body rotation on that left side

4.) repeat procedure with the patient’s head turned to the opposite side

Right Cervical Syndrome (RCS)

patient’s head is turned to the right, palpate left side of cervical spine, left posterior body rotation

Left Cervical Syndrome (LCS)

patient’s head is turned to the left, palpate the right side of the cervical spine, right posterior body rotation

No Cervical Syndrome (NCS)

there was no change present with the patient turning their head

AD

anatomical deficiency

Bilateral Cervical Syndrome (BCS)

1.) positive when the patient turns their head bilaterally

2.) right body rotation at one level, left body rotation at another

3.) possible occiput problem

PRS

1.) decreased extension, decreased right rotation, decreased right lateral bend

2.) torque → clockwise

PLS

1.) decreased extension, decreased left rotation, decreased left lateral bend

2.) torque → counter-clockwise

PR-L/T/M (global curvature on the left)

decreased extension and decreased right rotation

PL-L/T/M (global curvature on the right)

decreased extension and decreased left rotation

PRI-L/T/M

1.) decreased extension, decreased right rotation, decreased left lateral bend

2.) torque → counter clockwise

PLI-L/T/M

1.) decreased extension, decreased left rotation, decreased right lateral bend

2.) torque → clockwise