Purpose of Bikele’s Sign : To determine if there are neurologic symptoms when the arm is abducted, laterally rotated and elbow is extended.

Patient position: Sitting upright with back unsupported and with arms beside the trunk.

Examiner position: Standing behind the patient.

Procedure: This test is performed in two steps: (1) The patient raises the arm sideways up to 90 degrees with the elbow fully flexed; (2) then, the arm is extended at the shoulder joint, followed by the extension of the elbow joint.

Outcome: The test is positive if radicular pain or other neurologic symptoms are felt on extending the shoulder joint and elbow joint. A positive bikele’s sign indicates a nerve root tension, brachial plexus neuritis and/or meningitis.

Reference:

1. Evans RC. Illustrated Orthopedic Physical Assessment: Mosby/Elsevier; 2009.
2. Magee DJ. Orthopedic physical assessment-E-Book: Elsevier Health Sciences; 2014.
3. Woessner DA, Webb CW. Chapter 10 – Physical Examination of the Cervical and Thoracic Spine A2 – Seidenberg, Peter H. In: Beutler AI, editor. The Sports Medicine Resource Manual. Philadelphia: W.B. Saunders; 2008. p. 90-9.