Schober Test Interpretation — SCE Rheumatology MCQ

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EasySpondyloarthropathySchober Test InterpretationSCE Rheumatology

A 45-year-old man with radiographic axial spondyloarthritis undergoes an original Schober test. With him standing, the rheumatologist marks the lumbosacral junction and a second point 10 cm above it. On maximum forward flexion, the distance between the marks increases to 13 cm. What does this result indicate?

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Correct answer: C — Restricted lumbar flexion

The correct answer is C. The distance increased from 10 cm to 13 cm, giving a Schober excursion of only 3 cm. By conventional clinical interpretation, an increase of approximately 5 cm or more indicates preserved flexion, so this result demonstrates restricted sagittal lumbar mobility, as may occur in axial spondyloarthritis. It does not assess cervical rotation or thoracic expansion, and a reduced excursion is the opposite of hypermobility. The test is interpretable: a 10 cm baseline span is used in the original Schober test. Modified versions may use additional landmarks or a 15 cm baseline span. The 5 cm threshold is an examination convention rather than an infallible diagnostic boundary; Schober testing is best used alongside other spinal mobility measures and for serial assessment.

Reference: Taheri N et al. Schober test is not a valid assessment tool for lumbar mobility. Scientific Reports. 2024;14:5451. https://pubmed.ncbi.nlm.nih.gov/38443445/