What type of patient is indicated to have a positive Kernig's sign?

A positive Kernig's sign is an important clinical indication often associated with meningeal irritation or conditions such as meningitis. This test assesses for stiffness in the meninges surrounding the brain and spinal cord. It is elicited by having the patient lie supine with their hips and knees flexed. When the examiner attempts to straighten the patient's leg at the knee while the hip remains flexed, pain or resistance that inhibits this movement indicates a positive sign.

In this context, having a supine patient with the knees and hips flexed indicates that the test can be performed correctly. If the patient experiences pain or resistance when attempting to extend the leg, this reaction suggests potential meningeal irritation or dysfunction.

The other options do not apply to the Kernig's sign because they either describe different clinical conditions unrelated to meningeal irritation or specify positions that do not facilitate the execution of the test. For instance, a patient with a herniated disc may present with radicular pain or other symptoms, but this does not inherently indicate a positive Kernig's sign. Similarly, a standing patient with lower back pain or a patient with a dislocated shoulder would not be relevant for assessing meningeal signs as they do not provide the appropriate context for testing