[2:27 pm, 01/09/2026] cm: Sign of the day
FLESCH TEST
OCCIPUT - TO - WALL TEST
Simple clinical measurement used to check for abnormal forward rounding of the upper back , known as Thoracic hyperkyphosis or poor cervical mobility like in ANKYLOSING SPONDYLITIS.
Method
Ask the Pt to stand upright with their back against a flat wall
Position of the body- Heel, calves, buttocks & shoulders touch the wall.
Pt is asked to look straight ahead with their head level in a neutral position
Pt is asked to touch the occiput directly to the wall without tilting their chin up.
A distance of 5 cms to 6.5 cms (occiput to wall) more strongly correlate with severe hyperkyphosis like ANKYLOSING SPONDYLITIS
Occiput wall distance ( OWD) has shown to have sensitivity of 92.31% , specificity 76.47% to quantify kyphotic posture of the upper thoracic & cervical spine.
This posture results in anterior displacement of the centre of gravity & is supported by compensatory widening of the base of the support & lumber hyperlordosis making the pt more prone for falls.
Dr. Prabhakar K
Prof of Medicine
SDUMC, Kolar.
[2:30 pm, 01/09/2026] cm: 
👆The Narketpally sign was a test with a human name earlier!
[2:31 pm, 01/09/2026] cm: Gemini doesn't seem to know about this test!👇
The term "Flesch test" in relation to ankylosing spondylitis usually refers to readability formulas like the Flesch Reading Ease Score used in medical research to evaluate how easy online health articles are for patients to understand. There is no diagnostic "Flesch test" physical exam or blood test for ankylosing spondylitis (AS). [1]
How Doctors Diagnose Ankylosing Spondylitis
Doctors use a mix of clinical evaluations, blood work, and imaging tests rather than a single test:
* Physical and spinal tests: Doctors use specific movement checks like the Schober's Test to measure lower back flexibility and range of motion.
* Imaging studies: X-rays and MRIs look for inflammation and joint damage in the spine and sacroiliac joints.
* Blood tests: Labs check for inflammation markers like C-reactive protein (CRP) and the HLA-B27 genetic marker. [2, 3, 4, 5, 6, 7]
Readability in Health Education
* Medical researchers use the Flesch-Kincaid and Flesch Reading Ease metrics to check if patient guides on sites like the Mayo Clinic are written at a level that patients can easily comprehend.
* Explore a study on chatbot readability using these indices from PMC .
* View online material metrics in the study from ScienceDirect. [1, 8, 9]
[3] https://www.niams.nih.gov/health-topics/ankylosing-spondylitis/diagnosis-treatment-and-steps-to-take
[2:33 pm, 01/09/2026] cm: Okay Gemini appears to be picky about missing an "e" at the end!👇
The Occiput to Wall Distance, also called the Flesche test, measures the severity of forward spinal curvature and loss of cervical spine mobility in patients with Ankylosing Spondylitis. [1, 2]
How to Perform the Test
* Stand straight with your back against a flat wall.
* Keep your heels, calves, buttocks, and shoulders touching the wall.
* Look straight ahead with your head level.
* Try to move the back of your head (the occiput) back to touch the wall without tilting your chin up. [1, 3, 4]
Scoring and Measurement
* Normal result: The back of the head touches the wall easily, making the distance 0 cm.
* Abnormal result: The head cannot reach the wall due to tight neck joints or a forward-bending curve in the upper back (thoracic kyphosis).
* Measurement: A helper uses a tape measure or ruler to find the gap between the wall and your occiput.
* Clinical meaning: Higher numbers show worsening spinal posture and stiffness over time. [1, 2, 3, 4, 5]
Further Exploration
* Review a clinical breakdown on the Physiopedia entry.
* Read validity research in ScienceDirect . [1, 6]
