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Neck special tests quiz

Questions use only the figures on this library's test pages.

Last updated 30 October 2026. 8 questions. Each answer links to the test page it comes from; the region's tests are listed on the Neck cheat sheet.

Terms such as sensitivity, specificity, LR+ and LR− are explained in the glossary. A likelihood ratio above about 5 or below about 0.2 is doing real work; between 2 and 0.5 it is barely worth the time.

Question 1 of 8

Which of these tests best rules in cervical radiculopathy?

  1. Upper limb tension test (ULTT/ULNT A)
  2. Spurling's test
  3. Cervical rotation <60° (towards symptomatic side)
  4. None of them: on these figures all three are barely worth the time
Show the answer

Answer: B. Spurling's test. Spurling's test has the highest LR+, 3.28, against 2.45 for the upper limb tension test (ULTT/ULNT A) and 1.75 for cervical rotation <60°. Its page still calls a positive result a small shift: “a positive result nudges the diagnosis up, but does not settle it.” See the test

Question 2 of 8

How far does a positive result for cervical rotation less than 60° move the probability of cervical radiculopathy?

  1. Up clearly: it is doing real work (LR+ above about 5)
  2. Up a little: a small shift (LR+ between about 2 and 5)
  3. Barely: it is barely worth the time (LR+ below about 2)
  4. Down: a positive result makes it less likely
Show the answer

Answer: C. Barely: it is barely worth the time (LR+ below about 2). Cervical rotation <60° (towards symptomatic side): LR+ 1.75. Its page: “barely informative: a positive result changes little.” Its page also carries a caution; read it before relying on the result. See the test

Question 3 of 8

How far does a negative result for gait deviation (a normal gait) move the probability of cervical myelopathy?

  1. Down clearly: it is doing real work (LR− below about 0.2)
  2. Down a little: a small shift (LR− between about 0.2 and 0.5)
  3. Barely: it is barely worth the time (LR− above about 0.5)
  4. Up: a negative result makes it more likely
Show the answer

Answer: C. Barely: it is barely worth the time (LR− above about 0.5). Gait deviation / abnormality: LR− 0.85. Its page: “barely informative: a negative result changes little.” See the test

Question 4 of 8

What counts as a positive Spurling's test?

  1. Reproduction of the arm symptoms in a radicular pattern; local neck pain does not count.
  2. Rotation to one side of about 32° or less (more than about 10° below the normal of about 44°); a clear difference from the other side supports the finding.
  3. At least partial reproduction of the patient's familiar arm (or neck) symptoms that change with structural differentiation (increase with neck side-bending away from the painful side, ease with side-bending towards it or with releasing wrist extension).
  4. Easing or disappearance of the arm symptoms while the traction is held (a relief test).
Show the answer

Answer: A. Reproduction of the arm symptoms in a radicular pattern; local neck pain does not count. The Spurling's test page: “Reproduction of the arm symptoms in a radicular pattern; local neck pain does not count.” See the test

Question 5 of 8

What counts as a positive cervical distraction test?

  1. Easing or disappearance of the arm symptoms while the traction is held (a relief test).
  2. At least partial reproduction of the patient's familiar arm (or neck) symptoms that change with structural differentiation (increase with neck side-bending away from the painful side, ease with side-bending towards it or with releasing wrist extension).
  3. Arm-squeeze pain at least 3 points (out of 10) higher than at the AC joint and subacromial area.
  4. Reproduction of the arm symptoms in a radicular pattern; local neck pain does not count.
Show the answer

Answer: A. Easing or disappearance of the arm symptoms while the traction is held (a relief test). The Cervical distraction test page: “Easing or disappearance of the arm symptoms while the traction is held (a relief test).” See the test

Question 6 of 8

What counts as a positive Hoffmann's sign?

  1. Extension of the big toe, often with fanning of the other toes.
  2. Flexion and adduction of the thumb (often with the index finger); the two sides are compared.
  3. Flexion of the fingers, usually with a reduced brachioradialis response (an upper motor neuron sign around C5–6).
  4. Sustained rhythmic beating; a few beats that die away can be normal.
Show the answer

Answer: B. Flexion and adduction of the thumb (often with the index finger); the two sides are compared. The Hoffmann's sign page: “Flexion and adduction of the thumb (often with the index finger); the two sides are compared.” See the test

Question 7 of 8

Starting at 30% for cervical radiculopathy, what is the probability after a positive upper limb tension test?

  1. 15%
  2. 70%
  3. 58%
  4. 51%
Show the answer

Answer: D. 51%. From the ladder on the Upper limb tension test (ULTT/ULNT A) page: a starting 30% becomes 51% after a positive (LR+ 2.45: a small shift). Its page also carries a caution; read it before relying on the result. See the test

Question 8 of 8

Starting at 30% for clinically important cervical spine injury after blunt trauma (need for imaging), what is the probability after a positive result on the Canadian C-Spine Rule?

  1. 44%
  2. 70%
  3. under 1%
  4. 94%
Show the answer

Answer: A. 44%. From the ladder on the Canadian C-Spine Rule page: a starting 30% becomes 44% after a positive (LR+ 1.81: barely informative). Its page also carries a caution; read it before relying on the result. See the test

Other quizzes: Shoulder · Knee · Low back & pelvis · Hip, groin & thigh · Foot, ankle & calf · Elbow & forearm · Wrist & hand. How the figures are chosen: Methods.

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

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