Under what circumstances is Trendelenburg sign / gait seen in the MS setting? Does it ever occur with footdrop? In a patient catching toe when walking, is the catching possibly related to the hip drop? What would cause Trendelenburg sign if related to MS? What are the differential diagnoses?
The Trendelenburg sign is a term used to describe a type of gait deviation. It can be seen in anyone, and is associated with weakness of the hip abductor muscles. It can occur with foot drop, but both can occur independently of each other as well. A Trendelenburg sign is not the cause of a foot drop. Foot drop either occurs due to weakness in the tibialis anterior muscle, spasticity of the plantarflexors (calf muscles) or sometimes can be more pronounced with weakness of the hip flexors (not abductors). Differential diagnosis would be muscle strength testing (MMT) of the lower extremities, to determine which muscle groups are weak.
Sarah Frank, PT, DPT, MSCS
Mt. Sinai Rehabilitation Hospital
490 Blue Hills Ave.
Hartford, CT 06112