Neck Orthopaedic Test: Sharp Purser Test

The Sharp-Purser test is a physical examination technique used to assess the integrity of the transverse ligament, which is an important stabilizing structure of the upper cervical spine.

Here are the steps to perform the Sharp-Purser test:

1. Position the patient in a seated position with their head and neck in a neutral position.
2. Stand behind the patient and place one hand on their forehead and the other hand on the posterior aspect of their C2 spinous process.
3. Instruct the patient to keep their mouth closed and to resist any movement of their head or neck.
4. Apply a gentle force to the patient's forehead while simultaneously pushing the C2 spinous process posteriorly.
5. Observe the patient's response during the test. A positive finding is indicated by a "clunk" or a "shift" in the cervical spine, while a negative finding indicates no movement or discomfort.

The test is considered positive if the patient experiences a "clunk" or a "shift" in their cervical spine during the test, which may indicate laxity or instability of the transverse ligament.