Sharp Purser | Transverse Ligament Integrity

-- PURPOSE --
Assess the integrity of the transverse ligament

-- PATIENT POSITION --
Sitting

-- TECHNIQUE --
► Place palm of one hand on patient's forehead
► Other hand is placed at C2 spinous process using a pincer grasp (thumb and index finger)
► Perform a posteriorly directed force with the hand that is on the patient's forehead, while stabilizing with the other hand

-- POSITIVE TEST --
Excessive displacement during posterior translation or decrease in symptoms

-- SENSITIVITY AND SPECIFICITY --
► Sensitivity: 69%
► Specificity: 96%
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* REFERENCES *
Mansfield CJ, Domnisch C, Iglar L, Boucher L, Onate J, Briggs M. Systematic review of the diagnostic accuracy, reliability, and safety of the sharp-purser test. J Man Manip Ther. 2020;28(2):72-81. doi:10.1080/10669817.2019.1667045
Uitvlugt G, Indenbaum S. Clinical assessment of atlantoaxial instability using the Sharp-Purser test. Arthritis and Rheumatism 1988;31(7):918-922.
Kauppi M, Leppanin L, Heikkila S, Lahtinen T, Kautiainen H. Active conservative treatment of atlantioaxial subluxation in rheumatoid arthritis. British J Rheum 1998;37:417-420.
Uitvlugt G, Indenbaum S. Clinical assessment of atlantoaxial instability using the Sharp-Purser test. Arthritis and Rheumatism 1988;31(7):918-922.
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* This is not medical advice *
This content is intended as educational material for healthcare professionals and healthcare students. Patients should seek medical advice from a healthcare professional.