Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
The article on testing the reflexes was a welcome relief from the uncertainties of politics and statistics. The usual technique is so well known, even by children, that anticipation of being hit can make it difficult. I offer an alternative.
The leg lies extended and relaxed on the couch.. The first part of the procedure is to put the quadriceps on the stretch. The index finger is placed across the tendon above the patella which is pushed toward the foot.
Then the child is told that I am going to hit my finger, not their leg. The hammer hits the side of my finger which produces the sudden extra stretch needed to elicit the reflex