Quadrant Test (Kemp's Test): Facet Joint & Stenosis Check

The Quadrant Test, often referred to as Kemp's Test, is a provocative maneuver used to assess the lower back. By placing the spine in extension, rotation, and side-bending, it helps differentiate between facet joint pain and nerve root compression.

1. Purpose

The primary purpose of the Quadrant Test (also known as Kemp's Test) is to **assess the lumbar spine** for facet joint pathology and intervertebral foramen stenosis. It mechanically narrows the foramen and maximally loads the facet joints on the tested side.

2. How to Perform

1. The patient is positioned in standing (preferred) or sitting.
2. The examiner stands behind the patient for stability.
3. The patient is instructed to extend their spine (lean back).
4. While extended, the patient laterally flexes (side bends) and rotates towards the affected side. (Think of sliding your hand down the back of your thigh).
5. The examiner may apply gentle overpressure through the shoulders to increase the load on the facets and foramen.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
The interpretation depends on where the pain is felt:

• Localized low back pain: Suggests lumbar facet joint irritation or degeneration (Facet Syndrome).
• Radiating leg pain (sciatica): Suggests nerve root compression. The maneuver narrows the intervertebral foramen, impinging the nerve (Lateral Stenosis).

Negative Sign (Test is NEGATIVE):
A negative test is the absence of pain or reproduction of symptoms.