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Soto-Hall test. This test is primarily employed when fracture of a vertebra is suspected. The patient is placed supine [lying on back] without pillows. One hand of the examiner is placed on the sternum of the patient, and mild pressure is exerted to prevent flexion at either the lumbar or thoracic regions of the spine. The other hand of the examiner is placed under the patient's occiput [back of the head], and the head is slowly flexed toward the chest. Flexion of the head and neck on the chest progressively produces a pull on the posterior spinous ligaments from above, and when the spinous process of the injured vertebra is reached, an acute local pain is experienced by the patient.

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