Babinski sign
For: Cervical myelopathy
Compression of the spinal cord in the neck, usually from degenerative narrowing. It can cause clumsy hands, unsteady walking, symptoms in both arms or the legs, and brisk reflexes, though these signs are often absent early.
Rule-in strength not calculable (no false positives seen)Caution: No false positives among the controls, but only 7% sensitivity; the lower confidence limit for LR+ is about 2.9.
What the numbers mean
- Positive result: no false positives were seen in the study, so no likelihood ratio can be calculated. How far to trust that depends on how many people without the condition were studied.
- Negative result: barely informative: a negative result changes little.
Source
Cook C, Brown C, Isaacs R, Roman M, Davis S, Richardson W. Clustered clinical findings for diagnosis of cervical spine myelopathy. J Man Manip Ther. 2010;18(4):175–180. Journal article (DOI) · single study
Figures as they will appear in Rule It In, Rule It Out (Trokos, forthcoming). If a newer or better study changes them, this page changes with the book. Figures last updated from the book on 2 October 2026.
Get the book for the neck questions that matter: nerve root or referred pain, which myelopathy signs count, and when a neck after trauma needs imaging
This page gives the published figures. Rule It In, Rule It Out adds how to do this test, what counts as positive, how to read the result, and, where studied, whether combining it with other tests helps.
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One study, one test, once a month
Rule It In is a free evidence letter for musculoskeletal clinicians: one recent study explained, one examination test with its real numbers. From Trokos, publisher of Rule It In, Rule It Out.