Execution
- 1Position the patient supine and perform passive straight leg raise on the symptomatic side.
- 2Note the range at which pain or limitation occurs.
- 3Flex the knee to reduce hamstring tension.
- 4Passively flex the hip again with the knee bent.
- 5Compare whether hip flexion remains limited despite knee flexion.
Positive outcome
The sign is positive when SLR is limited and passive hip flexion remains limited even with the knee flexed. Normally, bending the knee should allow more hip flexion if hamstring length is the limiting factor. A positive sign may indicate serious buttock-region pathology such as neoplasm, abscess, ischial bursitis, severe hamstring origin pathology, or other nonmechanical causes.
CommentMagee treats the sign of the buttock as an important warning sign rather than a tendon-specific test. Because it may indicate serious pathology, a positive result should prompt careful differential assessment and likely imaging or medical referral. Value is high as a red-flag screen even though formal LR data are limited.
High Clinical Value