special test for the knee Flashcards

1
Q

valgus stress test

A

purpose: test for integrity of MCL

pt pos.: supine

prac. pos: standing next to pt. with one hand of the distal leg and other hand on the lateral side of the knee

procedure: force is applied medially. while distant hand does external rotation on the leg. done at both 0 degrees and 30 degrees

positive: pain and/or laxity

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2
Q

varus stress test

A

purpose: test integrity of LCL

pt pos.: supine

prac. pos: standing between pt. legs with one hand on distal leg and other on medial knee

procedure: force is applied laterally. while distant hand does internal rotation on the leg. done at both 0 degrees and 30 degrees

positive: pain and/or laxity

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3
Q

Lachman’s test

A

purpose: integrity of acl

pt pos.: supine with knee flexed to 30 degrees

prac. pos: standing next to pt., one hand stabilizing anterior distal femur and other hand one the posterior proximal calf

procedure: an anterior force is applied at the calf

positive: pain and/or laxity

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4
Q

Lelli’s test

A

purpose: test ACL

pt pos.: supine with knees flexed to 20-30 degrees

prac. pos: standing next to pt., one hand as a fist under the calf belly, one hand on anterior thigh

procedure: force is applied straight down with thigh hand

positive: foot not leaving the table. normal response is foot elevating from table

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5
Q

pivot shift test

A

purpose: test ACL

pt pos.: supine

prac. pos: at side of pt. one hand on distal tibia and opposite thumb posterior to the proximal fibula head.

procedure: internal rotation is obtained by rotating the distal hand and a valgus force is applied to the knee. Knee is taken into flexion and extension while maintaining the internal rotation and valgus force

positive: pain, apprehension, and visual “clunk” at 30 degrees of flexion

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6
Q

anterior drawer test

A

purpose: ACL

pt pos.: supine with knee flexed to 90 degrees and foot on table

prac. pos: slightly Sit on foot. both hands grasping the flexed proximal tibia

procedure: making sure hamstrings are relaxed. anterior force is then applied to the proximal tibia

positive: pain and/or laxity

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7
Q

posterior drawer test

A

purpose: PCL

pt pos.: supine with knee flexed to 90 degrees and foot on table

prac. pos: slightly Sit on foot. both hands grasping the flexed proximal tibia

procedure: making sure hamstrings are relaxed. posterior force is then applied to the proximal tibia

positive: pain and/or laxity

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8
Q

posterior sag sign

A

purpose: PCL

pt pos.: supine

prac. pos: at foot of pt. with hands under both heals

procedure: pt. legs are lifted off the table and observation is made of the tibial tuberosity’s height

positive: sagging of the tibia, posterior translation

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9
Q

Godfrey’s test

A

purpose: PCL

pt pos.: supine with knee flexed to 90 degrees and hips flexed to 90 degrees

prac. pos: at foot or side of pt. supporting the feet

procedure: making sure hamstrings are relaxed. hold both heals equally

positive: sagging of tibia on the injured side

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10
Q

Quadriceps active test

A

purpose: PCL

pt pos.: supine with hips flexed to 45 degrees and knees flexed to 90 degrees, foot flat on table

prac. pos: at foot of patient, stabilizing the foot

procedure: pt is instructed to flex the quad while the practitioner holds foot in place

positive: anterior translation of the tibia on the femur as the quads pull the tibia back into place

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11
Q

slocum test

A

purpose: anterior lateral rotatory instability

pt pos.: supine with knees flexed to 90 degrees and foot stabilized on the table. tibia externally rotated

prac. pos: at foot or next to pt. both hands on posterior proximal calf

procedure: anterior force is applied through joint line. attempted to move the tibia anteriorly. exactly like anterior drawer but with foot internally rotated

positive: pain and/or laxity, rotation of the tibia

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12
Q

MCmurray’s test

A

purpose: meniscal tears

pt pos.: supine with knee Brought to test

prac. pos: standing next to pt. one hand on distal leg and one hand on joint line of knee

procedure: for
medial meniscal tears: externally rotate leg and varus stress is applied with knee extension
lateral mensical tears: internally rotate leg and valgus stress is applied with knee extension

positive: pain, snapping, popping, catching

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13
Q

bounce home

A

purpose: meniscal tear (primarily anterior side)

pt pos.: sitting or supine

prac. pos: standing at foot or next to pt. one hand on distal tibia and the other behind the knee

procedure: slight flexion (5-7 degrees) is passively obtained while supporting the leg off the table. then knee is allowed to freely drop into extension

positive: pain, inability to allow movement, apprehension

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14
Q

Apley’s test (compression and distraction)

A

purpose: meniscal tear, posterior corner of meniscus

pt pos.: prone with knee flexed to 90 degrees

prac. pos: standing next to pt. one hand on heel, the other on distal tibia (compression), one hand on distal tibia, the other stabilizing at distal hamstring (distraction)

procedure: pressure is applied through the heel while rotating tibia internally (lateral meniscus) or externally (medial meniscus)

positive: pain with compression portion that is alleviated with distraction indicates meniscal tear

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15
Q

Thessally

A

GOLD STANDARD FOR MENISCUS INJURY

purpose: meniscal tear

pt pos.: standing on symptomatic leg with hands on prac. shoulders. leg should be partially flexed (5 and 20 degrees)

prac. pos: sitting on a stool or kneeling in front of pt. with hands on hips of pt.

procedure: pt. is instructed to rotate to both sides, using the prac. for balance. Rotation is done at both 5 and 20 degrees of flexion

positive: pain, catching, clicking, or an inability to bear weight

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16
Q

Ege’s test

A

purpose: meniscal tear

pt pos.: standing in front of a wall. legs are externally (medial meniscus) or internally rotated (lateral meniscus) to end of ROM

prac. pos: standing next to pt. available for balance or catching

procedure: pt. is instructed to perform a complete squat

positive: pain, catching, clicking at the joint line. (externally rotate=medial meniscus) (internal rotate= lateral meniscus)

17
Q

clark/ grind test

A

purpose: test for chondromalacia

pt pos.: long sitting or supine on table

prac. pos: 1. standing next to pt. with hands on top of patella, 2. standing next to pt., web space of thumb and first finger is placed on superior patella and a pressure is applied

procedure: 1. while legs are extended push the patella down and move it around. 2. pt. is instructed to contract quadriceps while prac. has web over superior patella

positive: pain, grinding, apprehension by pt.

18
Q

apprehension

A

purpose: subluxation of the patella, sprain of the medial patellofemoral ligament (MPFL)

pt pos.: sitting or supine on table

prac. pos: standing next to pt., fingers or thumb over medial patella. stand on opposite side of testing knee.

procedure: patella is moved laterally

positive: pain, apprehension, click

19
Q

Sweep test

A

purpose: intracapsular knee swelling

pt pos.: sitting or supine on table

prac. pos: standing next to pt., one hand beginning distal to medial knee

procedure: prac. “sweeps” several times, running hand along medial knee. push capsular fluid sac from lateral knee to medial knee

positive: a “wave” of fluid is seen returning to the medial side of knee

20
Q

Ballotment

A

purpose: Intracapsular or extracapsular swelling

pt pos.: sitting or supine on table

prac. pos: standing next to pt. both hands “milk” above and below knee, bring all fluids to the knee

procedure: bring all swelling into the knee and push down on patella

positive: after pushing patella straight down, if patella floats back up to the surface (ping pong=intracapsular), if patella stays down (rock=extracapsular)

21
Q

Intracapsular vs. extracapsular

A

Intracapsular: ACL, Meniscus, or Osteochondral disease

extracapsular: plica, bursitis, MCL/LCL, tendonitis