What is the present finding with the Bowstring Sign?

• A. Pain is only felt during the straight leg raise
• B. Pain is reproduced through any portion of the sequence
• C. Pain is absent regardless of position
• D. Pain only occurs when the knee is flexed

Answer: (B)

The Bowstring Sign is a clinical test used to assess for the presence of neurological involvement, particularly related to nerve root irritation in the lower extremities. When the Bowstring Sign is positive, pain is reproduced throughout any portion of the testing sequence, indicating irritation or compression of the sciatic nerve or its branches.

During the test, the clinician typically raises the patient's leg while keeping the knee straight, which can cause tension in the sciatic nerve. If pain occurs during this movement, or if it is elicited at any point during the sequential testing (including flexing the knee or other maneuvers), it suggests that there may be an underlying issue related to nerve irritation.

In contrast, the other options present findings that do not align with what is typically observed with a positive Bowstring Sign. For example, if pain were only felt during the straight leg raise, it would not account for the other potential positions and movements that might also induce pain, thus highlighting the importance of the comprehensive nature of the test.