Neurology Book

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Heel Knee Shin Test

Aka: Heel Knee Shin Test, Heel-Knee-Shin
  1. See Also
    1. Cerebellar Function Test
    2. Finger-Nose-Finger Test
    3. Heel Knee Shin Test
    4. Romberg Test
    5. Rapid Alternating Movements (Dysdiadochokinesia)
  2. Indications
    1. Cerebellar Function evaluation
  3. Technique
    1. Patient lies supine, with eyes closed
    2. Patient flexes knee, and places their heel against the opposite knee
    3. Patient extends their knee, allowing their heel to glide across the opposite leg, down the shin to the great toe
    4. Observe for smoothness and accuracy
    5. Repeat with the opposite leg
  4. Interpretation: Abnormal Findings
    1. Abnormalities suggest cerebellar disease
    2. Heel may overshoot the knee or fall to either side of the shin as it descends the opposite leg
    3. Heel may be held elevated above the leg (not in contact) in a patient with lost proprioception
  5. References
    1. Bates (1991) Physical Exam, Lippincott, Philadelphia, p. 531

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