Execution
- 1Position the patient standing and stand behind the patient.
- 2Stabilize the ipsilateral ilium if needed.
- 3Guide the patient into lumbar extension while controlling the shoulders and head.
- 4Add side flexion and rotation toward the side of pain.
- 5Continue only until end range or symptom reproduction.
Positive outcome
Reproduction of the patient’s symptoms is positive. Ipsilateral local low back pain suggests facet or zygapophyseal joint provocation on the side of rotation. Reproduction of leg symptoms may reflect foraminal narrowing or neural compression rather than isolated facet pain.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Stuber et al. (2014) — systematic review | NA | NA | NA | NA | NA |
| Laslett et al. (2006) | NA | NA | NA | NA | NA |
CommentMagee describes quadrant / Kemp as maximum foraminal narrowing and facet stress to the side of rotation. Systematic reviews conclude that Kemp’s test has limited diagnostic accuracy for facet joint pain compared with controlled blocks. It is a useful provocation screen, but local pain should not be treated as proof of facet-mediated pain.
Low Clinical Value