Which physical examination sign is a classic indicator of meningitis?

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Kernig sign demonstrates meningeal irritation and is a classic indicator of meningitis. To test it, have the patient lie flat, flex the hip and knee to 90 degrees, then attempt to straighten the knee. If extending the knee causes pain in the hamstrings or a marked resistance due to hamstring spasm, that positive sign points to irritation of the meninges and nearby nerve roots from inflammation. In meningitis, the meninges are inflamed, and stretching the involved tissues with knee extension after hip flexion provokes this pain. While it's a traditional teaching point for meningitis, remember it isn’t perfectly sensitive or specific and should be interpreted alongside other findings such as fever, neck stiffness, and headache. The other signs listed assess different neural pathways: Babinski sign relates to corticospinal tract involvement, Romberg tests proprioception and balance, and Tinel sign indicates peripheral nerve irritation at a specific nerve site. In the right clinical context, a positive Kernig sign supports the concern for meningitis and prompts urgent evaluation.