A patient’s gait shows one leg lifted higher than the other, indicating a steppage pattern. Which nerve root is most commonly implicated?

A patient’s gait shows one leg lifted higher than the other, indicating a steppage pattern. Which nerve root is most commonly implicated?

• A. Drop Foot (S1)
• B. Pes Cavus (L5)
• C. Patella Alta (L3)
• D. Steppage Gait (L4)

Answer: (D)

Steppage gait signals weakness of the dorsiflexor muscles, especially the tibialis anterior, which makes it hard to lift the front of the foot during swing. The tibialis anterior is mainly driven by nerves from the L4 nerve root, so L4 radiculopathy is the classic root cause that leads to foot drop and a high-stepping gait to clear the foot. Among the options, the one that describes steppage gait linked to L4 best fits the observed pattern, because it ties the gait abnormality directly to dorsiflexor weakness at the L4 level. Other options point to different issues (a different root level or a different type of foot problem) and don’t explain the steppage pattern.

Steppage gait signals weakness of the dorsiflexor muscles, especially the tibialis anterior, which makes it hard to lift the front of the foot during swing. The tibialis anterior is mainly driven by nerves from the L4 nerve root, so L4 radiculopathy is the classic root cause that leads to foot drop and a high-stepping gait to clear the foot. Among the options, the one that describes steppage gait linked to L4 best fits the observed pattern, because it ties the gait abnormality directly to dorsiflexor weakness at the L4 level. Other options point to different issues (a different root level or a different type of foot problem) and don’t explain the steppage pattern.