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40 Cards in this Set

  • Front
  • Back
Valgus & Varus Test
(+) is laxity compared to the other side, pain over the LCL and MCL is not a (+). Laxity at 20° - MCL or LCL/Laxity at full extension - MCL, LCL, one of the cruciates.
Lachman’s Test
pg. 272
Two Causes of False (-)s?
Modified Version: placing your knee under the pts flexed knee of 25-30°, stabilize with hand & draw tibia anteriorly. PT is looking at how much the tibia translates forward & endpoint (should be “bang-stop”), abnormal endpoint would be a “mushy” feel.
Regular Version: holds the leg up & apply anterior translation on tibia
- False (-) due to tight hamstrings
- False (-) due to joint effusion/hemiarthrosis that can cause knee tightening
*used to assess ACL
*better test then Anterior Drawer
Anterior Drawer Test
pg. 274
False (-)s and False (+)?
Hip flexed to 45°, knee flexed to 90° with foot flat on the table, PT sits on foot and takes both hands behind the tibia & draws tibia anteriorly. PT is look at how much the tibia translates forward/laxity & endpoint (assessing the ACL).
- False (-) due to tight hamstrings
- False (+) due to torn PCL because the tibia will already be in a more posterior position so it looks like it is moving anteriorly but is really just coming from posterior to neutral
- False (-) due to joint effusion/hemiarthrosis that can cause knee tightening
Slocum Test
pg. 276-278
Anterior Drawer with IR & ER - IR in anterior drawer position but adding a rotary component which tests ant-lat instability (indicating torn ACL, popliteus, arcuate ligament, post-lat structures). ER for ant-med instability (indicating torn ACL or post-med structures).
Posterior Drawer Test
False (-)?
Similar to Anterior Drawer but apply force in posterior direction - laxity/endpoint (assessing PCL).
- False (-) due to gravity pulling the knee backwards - proceed to Sag Sign
Sag Test
pg. 267
Position supine (hook-line position) with heels even/knees flexed & look to see if tibial tuberosity and plateaus are even due to gravity pulling them backwards, (+) is uneven due to pulled back tibia (assessing PCL).
Godfrey 90/90 Test
pg. 266
Passively hold the legs in 90/90 and assess whether tibial tuberosity and plateaus are even, (+) is uneven due to pulled back tibia (assessing PCL).
Pivot Shift
pg. 280
Cup the heel, IR leg, provide axial load, & valgus force while moving the knee into slight flexion. Will normally obtain a clunk within 20°-30° of flexion, would get a reverse clunk when returning knee to neutral. Assessing ant-lat rotary instability/ACL - sublaxing knee if ACL is not intact, (+) is clunk or shift while performing motion.
McMurray’s Test
pg. 307
Start at 90-90, do a little scour test too. ER and valgus, extend knee. Then IR with varus and extend the knee.
(+) finding is pain, not just clicks & pops. Their pain will be at joint line, either medial or lateral, when they point to it so it’s a pain provocation test
*most commonly used test for the meniscus
Apley Compression Test
pg. 310
Prone with 90° of knee flexion, take heel and compress the tibial tuberosity into the table while IR & ER the tibia, (+) is pain.
- used for assessing meniscus
*Distraction Component - hold the thigh down and distract the tibia, should experience relief from meniscal pain/injury.
Bounce Test
pg. 252
Place knee into slight flexion & “bounce home” into extension, (+) is inability to bounce due to torn meniscus.
Spring Test
place the knee in hyperextension
- used to assess the anterior horn of meniscus
PF Grind Test
a.k.a. Clarke's Test
PT trying to provocate patellar knee pain (could be diagnosed as Chondromalacia - PTs can’t make this diagnosis - needs surgery to confirm), take webspace of hand and glide superior border of patella inferiorly while (gently) contracting the quads or take fingers and grind patella up/down/medially/laterally, (+) is reproduction of anterior knee pain.
Patellar Apprehension Test
pg. 242
PT movies patella laterally (without grinding), (+) if pt experiences apprehension or gently contracts the quads. Indicative of subluxation or dislocation of patella.
Patellar Ballotment Test
pg. 244
if you see swelling - the kneecap will float on the swelling like a bobber. If you push it down on a normal knee, it doesn’t do anything - on an effused knee, it will bounce up and down. Milk the effusion up, see the bulging coming up the other way
Unilateral SLR Test (Laseague’s)
pg. 159
Passive, pt is supine, pt holds the neck flexed, raise the leg up slowly until pain is present. If hamstrings are tight then perform 90-90 Test, lower the leg and then DF to see if pain still present. (+) if r. pain reproduced.
Sitting Root Test
pg. 156
Active, pt is short sitting, “look down at foot” & extend the knee, DF ankle. (+) if subject arches backwards or complains of r. pain in buttocks, posterior thigh, or calf. Indicative of Sciatic Nerve Pain.
Bilateral SLR Test
pg. 161
Passive, pt is supine, bilaterally raise leg until painful. (+) is r. pain reproduced, >70° = lumbar spine involvement, <70° = SI joint involvement.
Well SLR
pg. 163
Passive, pt is supine, flex uninvolved hip. (+) if r. pain in involved hip. Indicative of Vertebral Disk Damage
*Slump Test
pg. 165
Passive, pt is short sitting, flex the neck, ext the knee, & DF ankle. (+) if r. pain reproduced. Should get relief when posteriorly tilt the pelvis
Kernig/Brudzinski Test
pg. 150
Active, flex neck, slowly raise leg until painful, slightly lower leg to level of relief and flex the knee. Pt doesn't flex hip/knee no more then 90 degrees. (+) if r. pain reproduced.
*indicative of meningeal irritation, nerve root impingement, or dural irritation that is exaggerated by elongating the spinal cord
Hoover Test
pg. 148
Only perform when symptoms are all over the place - test for malingering/see if pt gives you full effort -pt is supine, heels in hands & lift heels off bed, ask to lift one leg at a time. Leg not being lifted should exert downward pressure into opposing hand for stabilization. (+) if not able to lift leg or no pressure/(-) if can’t lift leg and does give pressure.
Sign of the Buttock Test
pg. 165 D
Used to indicate an occupying space in Glut Max (tumor, hematoma, abscess), can be back or SI.
Pt lays supine, leg is passive SLR, lower the leg in response to pain. PT then flexes the hip to reproduce pain in the buttocks area, (+) is reproduction of pain
Valsalva Maneuver
Apply downward pressure as if producing bowel movement. (+) if r. pain reproduced.
Gaenslen’s Sign
pg. 200
Pt in supine, similar to Thomas Test with butt hanging off of bed, hold R knee & drop L knee off side of bed, apply pressure on L knee. (+) if pain reproduced in SI.
SI Joint Stress Test/Pelvic Rock Test
pg. 193
Provocation test, pt side lying, (+) trying to stretch the joint to reproduce symptoms, place hand on inner border of ASIS (crossing hands)& apply pressure, will stress SI since they are connected (gapping ASIS, compressing SI). Can also apply direct force on ASIS (compressing ASIS, gapping SI).
Gillet Test
pg. 191
Locate PSIS, hip has to flex 90° or higher, looking for rotation of pelvis, when R hip is flexed, thumbs should drop. This tells you which side is involved - which isn’t always the painful side. (+) if thumbs don’t drop and pelvis isn’t rotating like it should - proceed to Long Sit Test.
Long Sit Test
pg. 203
Have pt bend knee &amp; passively distract legs to relieve slack. Place hands on distal malleoli, measure. Help them up to sitting (since most people will wiggle up due to pain). (+) if change in leg length from supine to sitting position. If leg shortens = anterior rotated side, if leg lengthens = posterior rotated side.
Patrick/FABER Test
Place patient in figure 4 position and apply overpressure, (+) if pain is present
Scour test/quadrant test
Subject lies supine and examiner stands on involved side and passively flexes and adducts the subject’s hip. The subject’s knee is also placed in full flexion.
Apply downward pressure along the shaft of the femur while simultaneously adducting and externally rotating the hip. The examiner then adducts and internally rotates the hip while maintaining downward pressure.
Positive finding: pain
90-90 SLR
Pt. is supine, with opposite leg down to prevent substitution. The subject is instructed to actively extend their knee as much as possible and then do the other leg.
Positive finding: If the knee is flexed greater than 20 degrees, the hamstrings are considered tight.
Patrick/FABER test
Supine on table. Subject flexes, abducts, and externally rotates the involved leg until the foot rests on top of the knee of the uninvolved LE. The examiner then slowly abducts the involved lower extremity, bringing the knee closer toward the table. Knee on 1 hand on ASIS with overpressure
Positive finding: When the involved LE does not abduct below the level of the noninvolved LE. Pain in groin indicates hip joint, back is SI, and pulling is iliopsoas.
Thomas test
The subject lies supine with both knees fully flexed against the chest and the buttocks near the table edge. The examiner stands with one hand on the subject’s lumbar spine or iliac crest to monitor lumbar lordosis or pelvic tilt.
The subject slowly lowers the test leg until the leg is fully relaxed, or until either anterior pelvic tilting or an increase in lumbar lordosis occurs.
Positive finding: A lack of hip extension with knee flexion greater than 45 degrees is indicative of iliopsoas muscle tightness. Full hip extension with knee flexion less than 45 degrees is indicative of rectus femoris tightness. A lack of hip extension with knee flexion of less than 45 degrees is indicative of iliopsoas and rectus femoris tightness. Hip ER during any of the previous scenarios is indicative of IT band tightness.
Leg Length (true and apparent)
The pt. lies supine with hips and knees extended and parallel. Each leg should be perpendicular to a straight line between both ASIS’s.
TRUE: With a tape measure, the examiner measures from the most distal point of the ASIS to the most distal point of the medial malleolus.
APPARENT: umbilicus to medial malleolus (more for SI issues)
Positive finding: no real positive or negative results. Just note down the measurements in the O section.
Ober’s test
Subject lies on side with the hips and knees extended such that the test leg is superior to the nontest leg (i.e. make sure the pelvis is stacked in neutral). The examiner stands with the proximal hand stabilizing the pelvis and the distal hand supporting the lower leg to bring it into extension.
With the pelvis stabilized to prevent rolling, abduct and extend the test hip in order to position the IT band behind the greater trochanter, then allow the leg to slowly lower (keeping the leg in extension with distal hand).
Positive finding: The inability of the leg to adduct and touch the table is indicative of IT band (esp. TFL) tightness. The leg will react like a “springboard” since the leg remains abducted in mid-air.
Piriformis Test
Put patient into piriformis stretch for a couple of seconds (FABER position but bring knee to chest) – even though the piriformis is an external rotator, with hip flexion of > 90˚, ER puts piriformis on its max stretch.
Positive finding: This test isn’t just to feel the stretch. In order to be positive for piriformis syndrome, the pt. needs to have reproduction of their signs and symptoms distally.
Ely’s test
The subject lies prone and examiner stands on one side of the table next to the subject’s leg, placing one hand over the ipsilateral pelvic region.
The examiner passively flexes the subject’s knee and notes the reaction at the hip joint. The test is repeated on the other side for comparison.
Positive finding: If the hip also flexes (pelvis lifts up) when the knee is flexed, a tight rec fem is indicated.
Craig’s Test (anteversion/retroversion)
The patient lies prone with the affected leg’s knee flexed to 90 degrees. The examiner stands on the involved side and palpates the greater trochanter.
The examiner then passively IR and ER the femur until the greater trochanter is most prominent in the therapist’s hand. The patient is then asked to hold the hip in this position while the examiner measures the angle between the long axis of the tibia and vertical.
Positive finding: If the measured angle is greater than 15 degrees, femoral anteversion is indicated. If the measured angle is less than 8 degrees, femoral retroversion is indicated. Increased femoral anteversion leads to toeing-in and squinting patellae. Femoral retroversion leads to toeing-out position.
Trendelenberg test
Have patient stand on one leg and see if the pelvis stays symmetrical (you can do this by placing your hands on the iliac crest to see if it drops).
Positive finding: If the pelvis drops on the uninvolved side (or the stance leg can’t hold them up), they have a weak gluteus medius on the stance leg.
Thessaly Test
SLS, flex stance knee to 20 degrees, have them rotate.
*best sensitivity for meniscal problem