National Board of Chiropractic Examiners (NBCE) Practice Test

When flexing the patient's heel towards the contralateral buttock causes them to raise their pelvis off the table to avoid pain, this indicates which sign?

1. Patrick's Sign

2. Ely's Sign

3. Fabere Sign

4. Thigh thrust test

The correct answer is: Ely's Sign

The scenario described where a patient's heel is flexed towards the contralateral buttock, causing them to lift their pelvis off the table to avoid pain, is indicative of Ely's sign. This sign is specifically used to assess tightness in the rectus femoris muscle which can cause discomfort or pain when attempting to flex the knee while the hip is in extension. When the patient compensates by raising their pelvis, it suggests that they are experiencing significant discomfort associated with hip extension or rectus femoris tightness, confirming the presence of Ely's sign. In contrast, Patrick's sign, Fabere sign, and the thigh thrust test assess different conditions or areas. For instance, Patrick's sign (or FABER) evaluates for hip joint pathology or sacroiliac joint dysfunction by placing the leg in a figure-four position and applying pressure. The Fabere sign is similar and focuses on hip and sacroiliac joint issues as well. The thigh thrust test is focused on assessing sacroiliac joint instability or dysfunction by applying pressure downward through the femur. Each of these tests has its unique purpose, making Ely's sign distinctly linked to tightness in the rectus femoris muscle.