Purpose of Soto-Hall Test: To determine if there is a fracture or a lesion of the lower cervical and/or thoracic vertebral joints (1) or to apply traction on the spinal cord and find if there is mass such as a tumour (2).

Patient position: Supine lying.

Examiner position: Beside the patient, Standing at the patient’s head side.

Procedure: Perform the limb/joint positioning sequence in the following order:

1. Neutral alignment at the cervical, thoracic and lumbar spine, while the patient is on supine lying,
2. Perform cervical flexion, approximating the patient’s chin to chest, (or ask the patient to flex the head and neck), while applying pressure on the patient’s sternum,
3. Sensitizing position: Raise both legs 45 – 50 degrees and repeat cervical flexion (1).

Outcome: Soto-Hall Test is positive if the patient experiences sharp, electric, or lightning-like pain in the cervical and/or thoracic spine (1, 2).

Similar Tests: Hyndman’s sign (3), Lhermitte’s sign, Brudzinski sign, and Lindner’s test (4).

Reference:

1. Foreman SM, Croft AC. Whiplash Injuries: The Cervical Acceleration/deceleration Syndrome: Lippincott Williams & Wilkins; 2002.
2. Miller KJ. Orthopedic and Neurological Examination in a Flash: Lippincott Williams & Wilkins; 2008.
3. Campbell WW, DeJong RN. DeJong’s the Neurologic Examination: Lippincott Williams & Wilkins; 2005.
4. Miller KJ, Sittler MD, Corricelli DM, DiMura DN, Comerford JS. Combination testing in orthopedic and neurologic physical examination: a proposed model. Journal of chiropractic medicine. 2007;6(4):163-71.