Lumbar Quadrant Test (Kemp's Test)

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The Lumbar Quadrant test is designed to detect the involvement of the lumbar zygapophyseal joints. This test is also referred to as the Quadrant test, the Extension-Rotation Test, and the Kemp’s Test.

To perform this test, ask the patient to stand with their arms crossed in front of the chest. To test the right side, stabilize the patient’s pelvis, grasp the right shoulder, and then guide the patient into performing active extension, right lateral flexion, and posterior rotation. The final test position is designed to cause maximum loading of the zygapophyseal joints. This test is considered positive if pain is produced locally in the lumbar region. In some patients, irritation of the zygapophyseal joints may also cause referred pain to the lower extremity.

Leg pain may also be due to compression of nerve roots from disc herniation or foraminal encroachment. This is because the final test position causes compression of the discs posterolaterally and reduces the size of the intervertebral foramen. This test may also be performed with the patient in the seated position.