Video – Tragus to Wall Test

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Tragus to Wall Test

The Tragus to Wall test is designed to measure the degree of flexion deformity of the cervical spine as often seen in ankylosing spondylitis. To perform the test, ask the patient to stand with their heels, buttocks and thoracic spine placed against a wall. Now, ask the patient to keep their head in the neutral position and attempt to bring their head backward to touch the wall. Normally, the skull should reach the wall.  If the patient is unable to reach the wall, it indicates a cervical flexion deformity. Measure and record the distance between the tragus of the ear and the wall. This provides a baseline measure for future comparison to monitor the increase in cervical flexion deformity over time as seen in ankylosing spondylitis. A similar test called the Occiput to Wall test measures the distance between the back of the skull and the wall. Please note that the inability to touch the skull against the wall may be due to other causes of reduced extension in the cervical spine. In addition, patients who have an increased thoracic kyphosis will also have difficulty in touching their skull to the wall even though their cervical range of motion may be normal.

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