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70 Cards in this Set
- Front
- Back
Anterior and Posterior Drawer's Foot Sign
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Passive, supine Anterior: Stabilize the tibia, and pull calcaneus Posterior: Stabilize the foot dorsum, and pull the tibia anteriorly Posterior (+) ↑gapping = a tear of the posterior talofibular ligament |
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Dorsiflexion Test
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Passive, seated With the knee flexed, dorsiflex the foot |
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Forefoot Adduction Test (Pediatric)
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Passive, seated Grasp the child’s ankle with thumb and index fingers, passively abduct the forefoot by pushing on the medial side of the 1st metatarsal head |
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Forefoot Squeeze Test (Morton's)
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Passive, supine or seated Apply transverse pressure across the heads of the metatarsals |
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Homan's Sign
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Passive, supine Knee flexed Dorsiflex the foot and squeeze the calf (+) ↑ pain at the posterior leg or calf: thrombophlebitis |
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Talor Tilt Test
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Passive, seated Adduct (invert, supinate, varus) foot |
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Test for Rigid or Supple Flat Feet
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Passive and active Seated and standing Observe the patient’s feet while seated (non-weight bearing of feet) or standing (weight bearing)
(+) medial longitudinal arch absent in all positions: rigid flat feet (+) medial longitudinal arch absent only when standing: supple flat feet that can be corrected with longitudinal arch supports |
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Thompson (squeeze) Test
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Passive, prone Squeeze the calf muscles observing for plantar-flexion of the foot
(+) lack of plantar flexion: Achilles tendon rupture |
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Tibial Torsion Test
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Passive, seated Draw a straight line between the two melleoli, and a line from the tibial tubercle and the ankle joint
Test for internal torsion of the tibia ( - ): the line drawn between the two malleoli is rotated externally 15° from a perpendicular line drawn from the tibial tubercle to the ankle ( + ) the malleolar line faces directly anterior, close to the perpendicular line: internal tibial torsion |
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Adam's Sign |
Active, standing, shoes off Stand behind pt, examine spine as patient flexes ↓ angle: functional scoliosis, usually < 25° No change: structural deformity (hemivertebra, compression fracture) |
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Adson's Test
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Active, seated Monitor radial pulse while taking a deep breath and rotating the head towards involved side and extending the neck
Test for TOS compression of subclavian artery and/or brachial plexus (+) ↓ pulse: Scalenus anterior, cervical rib problem or mass (Pancoast tumor) Paresthesia or radiculopathy of upper extremity: compression of neural components of brachial plexus Reverse |
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Braggard Test |
• Passive, supine Test for lumbar radicular pain |
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Bhecterew Test
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• Active, other knee, then both |
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Burns Bench Test
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• Kneeling on the exam table • Stabilize pts legs at the ankle joint • Instruct pt to bend at the waist to touch the floor |
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Cervical Spine Compression Test
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Passive Seated Compression at neutral and rotated position B/L
Downward pressure causes: o Narrowing of Intervertebral foramina (IVF) o Compression of apophyseal joints in cervical spines o Compression of intervertebral disc in cervical spine (+) Local pain: foraminal encroachment w/o nerve root pressure or apophyseal capsulitis (+) Radicular pain: foraminal encroachment w/ nerve root compression If suspect nerve root involvement, evaluate neurological level |
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Cervical Spine Distraction Test
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Passive Seated Grasp beneath mastoid process (avoid face and TMJ) & lift up pt’s head
Stretch the cervical muscles, ligaments, and Z joint capsules. (+) local pain: muscle spasm, strain, sprain, facet capsulitis. (+) local or radicular pain: foraminal encroachment or disc defect |
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East Test (Roo's Test)
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Active, seated Pt abducts arms to 90°and flexes elbows 90°; instruct pt to open and close fists slowly for 3 min.
Test for TOS (+) affected arm weakness and/or discoloration of hand |
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Hoover Test
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• Active, supine
• Place palm under heel of unaffected leg; ask pt to lift affected leg • Test for malingering LBP • (+) Pt will not raise the affected leg and NO posterior pressure on the unaffected heel side would be felt • If pt is genuinely trying to raise the leg but cannot do so, you should feel pressure from the unaffected heel |
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Kemp Test
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• Passive, seated
• Stabilize the PSIS w/ one hand • Reach around to front of pt & grasp shoulder w/ other hand • Rotate, laterally flex, and extend the trunk • Test for lumbar radicular pain • When pt bends obliquely backwards, the dural sac on the side of bending moves laterally • (+) ↑ Local pain: facet capsulitis, lumbar m. spasm • (+) ↑ Radicular ipsilateral pain: Lateral disc protrusion • (+) ↑ Radicular contra pain: medial disc protrusion |
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Kernig Test
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• Passive, supine ↑ temp, mental status changes |
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SLR (Lasegue Test)
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• Passive, supine • ↑ Stretch of sciatic nerve and spinal nerve pathology |
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Lindner Test
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Passive Supine Flex pt’s neck
↑ traction of dural sac and spinal cord causes pain (+) pain or flex knees to ↓ traction of cord and meninges: meingeal irritation or nerve root involvement. Head pain w/ sudden neck movements, neck stiffness, nuchal rigidity and ↑ temp: suspect bacterial meningitis immediate referral to ER |
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Milgram Test
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• Active, supine
• Raise and hold legs 3-6 inches off the table. • Hold for as long as possible • Test for Space occupying lesion (SOL) • ↑ Intrathecal pressure • Normally, should be able to perform test for > 30 seconds w/o LBP • (+) Low back pain (LBP): SOL |
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Minor Sign
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• Active, seated • Tell pt to stand up • (+) stand on painless side and flex leg on the painful side to ↓ tension of the sciatic nerve: sciatic radiculopathy on the side of flexed leg (pushes off uninvolved side leg or chair arm to get up) |
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Shoulder Depression Test
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Passive Seated Push down the shoulder and laterally flex pt’s head to opposite side
Muscles, ligaments, nerve roots, nerve root coverings, and brachial plexus are stretched & clavicle is depressed, approximating the 1st rib ↑ local pain on tested side: muscle spasm, adhesions, ligament injury. ↑ radicular pain: compression of the neurovascular bundle, adhesion of the dural sleeve, or thoracic outlet syndrome (TOS) ↑ pain on opposite side: foraminal enchroachment, facet, disc problem Brudzinski’s |
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Soto Hall Test
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Passive, supine Passive neck flexion with sternum stabilization
(+) ↑ Local pain: ligament, muscular, osseous, or cervical cord problem (+)↑ Radicular pain: disc problem |
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Valsalva Test
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Active Seated Take a deep breath, hold, and bear down
↑ Intrathecal pressure of entire spine (+) Pain at cervical region: Space occupying lesions (SOL) in the cervical canal or foramen |
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Vertebral Artery Test
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Patient rotates head opposite to tested side maximally and holds position for 10 seconds. Patient returns to neutral for 10 seconds. Patient extends head for 10 seconds. Patient returns to neutral for 10 seconds. Patient extends and rotates head (again opposite tested side) maximally for 10 seconds. Positive symptoms include (The 5 D’s) dizziness, diplopia, dysarthria, dysphagia, drop attacks, nausea and vomiting, sensory changes, nystagmus, etc.
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Wright (Hyperabduction) Test
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Passive, seated Establish the character of the radial pulse Monitor radial pulse while hyperabducting the arm Test for TOS (+) ↓ Pulse: compression of axillary artery by pectoralis minor muscle (spastic or hypertrophied) or by a deformed coracoid process |
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Apley Scratch Test
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Active, seated Touch contralateral scapula behind head from superior and inferior
↑ Stress on the rotator cuff tendons (+)↑ Pain: rotator cuff tendinitis (usually supraspinatus) |
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Drop Arm (Codman) Test
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Active, seated Abduct the arm to 90°, then ask pt to lower the arm slowly
(+) not able to lower the arm slowly or drops suddenly: rotator cuff tear (usually supraspinatus) The supraspinatus m. acts as an abductor of the arm and holds the head of the humerus in place |
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Glenohumeral Apprehension Test
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Passive, seated Abduct the affected arm 90° and externally rotate slowly while stabilizing the shoulder
Anterior glenohumeral instability test External rotation of the arm → dislocates the humerus anteriorly (+) local pain: chronic anterior shoulder dislocation (lack of integrity of the inferior glenohumeral ligament, anterior capsule, rotator cuff tendons, and glenoid labrum) |
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Impingement (Hawkins-Kennedy, Neer) Test
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Passive, seated Grasp the wrist and fully flex the arm
Test for supraspinatus tendinitis Movement jams the greater tubercle of the humerus against the acromion (+)↑ Pain: supraspinatus, bicep tendinitis (overuse injury) |
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Lippman Test
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Passive, seated , with the other hand palpate the biceps tendon and move arm from side to side
stress of the bicipital tendon and transverse humeral ligament (+) ↑ pain: bicipital tendinitis, ruptured transverse humeral ligamen |
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Speed Test
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Resisted, seated Arm extended, supinated, and shoulder flexed to 45°. Place fingers on the bicipital groove and with the other hand resist pt’s flexion of the shoulder
This test stresses the biceps tendon in the bicipital groove (+) ↑ pain at the bicipital groove: Bicipital tendinitis |
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Yergason Test
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Resisted, seated Flex pt’s elbow to 90°, stabilize the elbow with one hand, then instruct pt to externally rotate the shoulder and supinate the forearm against resistance
stress of the bicipital tendon and transverse humeral ligament (+) ↑ Local pain: bicipital tendinitis (+) displacement of bicipital tendon: rupture transverse humeral ligament |
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Cozen Test
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Resisted, seated Pt’s forearm is pronated Stabilize pt’s forearm and resist pt’s wrist extension Test for lateral epicondylitis The tendons that extend the wrist attach to the lateral epicondyle. These include: extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, and extensor carpi ulnaris The test can reproduce irritation to the already inflamed lateral epicondyle or common extensor tendon (+) ↑pain: Lateral epicondylitis (Tennis’ elbow) |
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Finkelstein Test
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Active and Passive Seated Ask pt to bring the thumb into the palm, make a fist, and ulnar deviate the fist
Test to determine presence of de Quervain’s disease (+) ↑ pain: tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons (de Quervatin’s dz) |
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Mill Test
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Passive, seated Pronate pt’s forearm and flex the wrist fully, then passively extend the elbow
Test for lateral epicondylitis Test stretches the muscle attachment and puts stress on the radial nerve (+) ↑ pain: Lateral epicondylitis |
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Phalen Test
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Active, seated Flex the wrists and place dorsal surface of hands together for 60 seconds
Test for paresthesia of the median nerve Flexor retinaculum ↑ compression of the median nerve (+) tingling in the hand (1st, 2nd, 3rd, and lateral half of the 4th digits): Carpal tunnel syndrome, anterior dislocation of lunate, arthritic changes, inflammation of the flexor retinuculum, tenosynovitis of the flexor digitorum tendons |
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Retinacular Test
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Passive, seated Test each digit individually Step 1: Hold MCP and PIP joints in neutral position while passively flexing DIP joint Step 2: Flex the PIP joint slightly, then passively flex the DIP joint
Test for joint capsule contraction or tight retinacular (collateral) ligaments (+) DIPs don’t flex when MCPs and PIPs are neutral: retinacular tightness or PIP capsule contraction (+) DIPs flex easily when the PIPs are flexed: flexing the PIPs relaxes the retinaculum, the capsule is normal but the retinaculum is tight |
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Tinel Sign
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Passive, seated Tap the palmar surface of the wrist over the carpal tunnel
Test for paresthesia of the median nerve (+) tingling of the hand (1st, 2nd, 3rd, and lateral half of the 4th digits): Carpal tunnel syndrome |
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Varus Stress Test
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Passive, seated Pt’s forearm is supinated Stabilize pt’s elbow while adducting the forearm (Varus of the elbow)
Test for lateral (radial) collateral ligament (+) ↑pain and gapping: lateral (radial) collateral ligament instability |
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Valgus Stress Test
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Passive, seated Pt’s forearm is supinated Stabilize pt’s elbow while abducting the forearm (Valgus of the elbow)
Test for medial (ulnar) collateral ligament (+) ↑pain and gapping: medial (ulnar) collateral ligament instability |
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Ely Test
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Observe for hip flexion or pelvis rising on the side being tested |
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Gaenslen Test
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Active, supine Instruct the pt to bring the knee to the chest on the unaffected side Then place downward pressure on the affected thigh until it is lower than the edge of the table
Extension of the leg stresses the SI joint and anterior SI joint ligament (+) pain at SI on affected side: SI lesion (anterior SI joint ligament sprain) or SI joint inflammation |
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Hibb Test
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Passive, prone Flex the knee and medially rotate the hip (move the leg outward) Palpate the SI joint for quality of movement and degree of opening
(+) ↑Pain at the SI joint: inflammation of the SI joint (+) ↑Pain at the hip: inflammation of ischiofemoral ligament (+) lack of motion: = SI joint restriction |
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Nachlas Test
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Passive, prone Knee flex bringing heel closer to the buttocks (ipsilateral)
(+) radicular pain: compression/irritation at L2-L4 by intradural lesion (disc defect, spur, SOL) (+) pain in SI/buttocks: consider SI joint lesion |
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Ober Test
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Passive, side lying (involved side up) Abduct and slightly extend pt’s upper leg with the knee straight Slowly lower the upper leg
(+) leg fails to fall into adducted position below the horizontal: contracture of TFL and/or IT band (+) pain over greater trochanter: trochanteric bursitis |
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Ortolani Click (Pediatric)
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Passive, supine Grasp both thighs with thumbs and index fingers at the lesser and greater trochanters respectively Then, flex and abduct the thighs bilaterally (+) Palpable/audible click: displacement of femoral head from acetabular cavity |
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Patrick (FABER) Test
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Passive, supine First flex the knee placing the foot flat on the table and press the thigh into the acetabular cavity. Then rest the heel on the opposite knee. Stabilize the opposite side ASIS and press down on the knee of the hip that is being tested (kind of making a figure 4)
Test for SI and acetabular dysfunction FABER: Flexion, ABduction, and External Rotation Test forces femoral head into acetabular cavity giving maximal congruence to the articular surfaces (+) hip pain: inflammation of the hip (+) pain due to trauma: fracture in acetabular cavity or femoral neck, avascular necrosis of femoral head |
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Pelvic Rock Test
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Passive, side lying (involved side up) Apply downward pressure on the ilium
Test for iliac compression (+) pain at SI: inflammation of SI joint, or ilium fracture |
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Telescoping Test (Pediatric)
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Passive, supine Flex hip and knee to 90°, push the femur down towards the table; then lift femur up away from the table
(+) excessive movement or a click: dislocated hip or potential to dislocate |
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Thomas Test
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Passive, supine Bring unaffected side of the knee to the chest Observe for hip flexion and palpate quads on the affected side Make sure lumbar spine is relatively flat on the table
Test for hip contracture (soft tissue stiffness that restricts joint motion) (+) ↑hip flexion or tightness of quads: hip flexors contracture, rectus femoris contracture, or restriction of hip joint |
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Trendelenburg Test
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Active, standing Support pt at the waist placing your thumbs at the PSIS’s Instruct pt to flex one leg (+) patient can’t stand due to pain or opposite hip falls or fails to raise (flexed hip side): weak gluteus medius on the standing side |
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Yeoman Test
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Passive, prone Place the hand over the SI joint of the involved side to stabilize the pelvis Grasp pt’s lower leg and passively flex the knee and extend the hip
(+) ↑ Pain: an inflammation of SI joint, or sprain of anterior sacroiliac, iliofemoral, or ischiofemoral ligament, an abscess in SI joint |
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Anterior Drawer Sign
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Passive, supine Flex the knee, grasp behind the knee and pull anterior (P A)
Test for ACL stability (+) > 5 mm of tibial movement on the femur: injury or tear of anterior cruciate ligament o Also consider: posterolateral capsule, posteromedial capsule, MCL (>1 cm movement), IT band, posterior oblique lig, arcuate-popliteus complex |
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Posterior Drawer Sign
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Passive, supine Flex the knee, grasp behind the knee and p posteriorly (A P )
Test for PCL stability (+) > 5 mm of tibial movement on the femur: injury or tear of posterior cruciate ligament o Also consider: posterior oblique lig, arcuate-popliteus complex, ACL |
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Apley Compression Test
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Passive, prone Flexed the knee and ankle to 90°, stabilize pt’s thigh w/ your knee; grasp pt’s ankle & place downward pressure while internally and externally rotating the flexed leg Test for meniscus instability (+) ↑ Pain or crepitus on either side of knee: injury of the meniscus on that side |
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Apley Distraction Test
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Passive, prone Flex the knee to 90°, stabilize the thigh, pull on the ankle while internally and and externally rotating the leg Test for ligamentous instability Distraction of knee takes pressure off the meniscus & puts strain on the medial and lateral collateral ligaments (+) ↑ Pain: non-specific ligament injury or instability |
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Apprehension Test (for patellar dislocation)
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Passive, supine Observe the patient’s face while extend the knee, and manually displace patella laterally
Test for patellofemoral dysfunction (+) ↑ Pain or look of apprehension in the patient’s face: lateral patella dislocation |
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Bounce Home Test
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Passive, supine Support pt’s leg at the knee and ankle, elevate leg off the table, and flex pt’s knee Passively extend pt’s leg
Test for meniscus lesion (+) inability to fully extend or “rubbery” feel on full extension: torn meniscus blocking full extension (+) pn at joint radiating up or down the leg: meniscus lesion |
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Lachman Test
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Passive, supine Flex the knee slightly (~30°), stabilize the femur, with other hand pull the leg anteriorly (P to A)
Test for ACL stability (+) Softened feel and anterior translation of the tibia: tear of ACL (more reliable than Anterior Drawer Test) |
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McMurray Test
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Passive, supine Flex the hip and knee Step 1. Externally rotate the leg (valgus stress) as you extend the leg Step 2. Internally rotate leg (varus stress) as you extend
Test for meniscus instability (+) A palpable or audible click: injury of the meniscus |
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Patello Femoral Grind Test (Including Clarke Test)
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Active, resisted, supine Step 1. Tract the patella inferior and ask the patient to contract quadriceps Step 2. Move the patella medially and laterally while pressing down
Test for patellofemoral dysfunction Step 1 (+) ↑ Pain: chondromalacia patella Step 2 (+) ↑ Pain under the patella: chondromalacia patellae, retropatellar arthritis, or a chondral fracture Step 2 (+) ↑ Pain over the patella: may indicate prepatellar bursitis |
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Reduction Click
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Same as McMurray’s test Passive, supine Flex the knee with internal or external rotation while extending the leg
Test for meniscus instability (+) An audible clicking sound: injured meniscus has slipped back into place |
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Valgus Stress Test
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Passive, supine Stabilize the knee from lateral side and abduct the leg (Valgus of the knee) by pushing leg laterally Repeat test in 20°-30° knee flexion
Test for MCL instability (+) ↑Pain medial aspect of the knee Ligament Stability Rating Scale Grade O No joint opening Grade 1+ < 0.5 cm joint opening Grade 2+ 0.5-1 cm joint opening Grade 3+ > 1 cm joint opening |
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Varus Stress Test
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Passive, supine Stabilizing the knee and adduct the leg (Varus of the knee) by pushing leg medially
Test for LCL instability (+) ↑Pain lateral aspect of the knee O No joint opening Grade 1+ < 0.5 cm joint opening Grade 2+ 0.5-1 cm joint opening Grade 3+ > 1 cm joint opening |
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Ballotable Patella Test
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Passive, supine With knee extended or slightly bent, apply light pressure or tap over patella Test for major effusion (+) floating patella over knee joint |
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Bulge Test
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Passive, supine With knee extended, apply brushing strokes towards the hip along the medial aspect of the patella. Then press on the lateral side of the patella looking for a wave of fluid to move medially Test for minor effusion (+) a wave of synovial fluid bulges just below the medial side of the inferior patellar border Note: this wave of fluid may take a few seconds to appear |