heel to shin (heel to knee) test

A test for dysmetria. Procedure: - with the patient supine & the legs extended, ask the patient to touch the left heel to the right knee, then slide the heel down the shin along the anterior surface of the tibia to the ankle - repeat the test using the contralateral heel/knee. Clinical significance: - cerebellar disease: - jerky, inaccurate movement with an action tremor during the slide down the shin - posterior column disease: - difficulty finding the contralateral knee with the shin, accompanied by a weaving motion down the skin or falling off the shin

References

DeGowin & DeGowin's Diagnostic Examination, 6th edition, RL DeGowin (ed), McGraw Hill, NY 1994, pg 799, 801