The Barlow test is used to detect posterior sublimations or dislocations. The test was developed by Dr. Thomas Geoffrey Barlow as a provocative technique for detecting hip instability.
How is the Test Performed?
Here is how the test is performed:
• The doctor should stand at the end of the examination table. He is facing away from the infant.
• One hand stabilizes the pelvis while the other hand grasps the knee and bends the hip to 90 degrees.
• The fingers of the examiner should be placed over the greater trochanter with the thumb resting on the inner side of the thigh.
• When the thigh is gently pulled inward, a force is applied to the bone in the back of the leg.
• The pressure on the knee is increased slightly while pushing backward.
• The Barlow Test is positive if the hip can be popped out of the socket with this maneuver. The dislocation will be felt if you try this.
What Is a Normal Barlow Test?
A normal test results in full extension and flexion of both hips with no pain or discomfort. Abnormal findings may indicate hip joint pathology such as developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis (SCFE), or Legg-Calve-Perthes disease.
If your child experiences any pain or discomfort during the Barlow test, consult the pediatrician for further evaluation. Early diagnosis and treatment of hip joint pathologies can prevent further damage and improve prognosis.
Positive Barlow Test Results
A positive Barlow test result usually means instability in the ankle joint. The instability can result from damage to the ligaments around the ankle or from an underlying medical condition. A positive Barlow test can help the doctor determine the best treatment plan.
The most common causes of a positive test results are:
• Ankle sprain – Damage to one or more of the ligaments surrounding the ankle can cause pain and swelling, leading to a positive test result.
• Ankle arthritis – Osteoarthritis is a degenerative disease that affects the joints. In people with ankle arthritis, the cartilage that cushions the bones within the joint wears away, leading to pain and swelling. This can cause a positive test result.
• Achilles tendonitis – Tendinitis is an inflammation of the Achilles tendon located at the back of the ankle. This condition can cause pain and swelling, leading to a positive test result.
• Gout – Gout is a type of arthritis that occurs when uric acid crystals form in the joints. These crystals can cause pain and swelling, leading to a positive test result.
• Infection – Infections such as cellulitis (a bacterial infection) can cause pain and swell around the ankle joint, leading to a positive test result.
• Tumor – A tumor can cause pain and swell in the ankle joint, leading to a positive test result.
Negative Barlow Test
A negative test result means that the doctor could not reproduce your symptoms by pushing or pulling on your joints. This suggests that your pain is not caused by problems with the surrounding muscles, ligaments, or tendons.
If you’re experiencing joint pain, a negative test result may help rule out certain conditions as potential causes.