Exam - joints

Question 1

What are specific signs of joint effusion in the knee?

Answer 1

Bulge sign & patellar tap

Question 2

What does Trendelenberg test indicate?

Answer 2

Trendelenberg test for abductor weakness at the hip

• A negative test (normal) - the patient can hold the non stance leg flexed for 30 seconds and the iliac crest on the non stance side is higher than the stance side
• A positive test (abnormal) - the patient is unable to achieve or maintain this position
• Interpretation of a positive test – generally weakness of the hip abductor muscles on the stance side often associated with osteoarthritis of that hip

Question 3

What does Thomas test indicate?

Answer 3

Thomas test to detect fixed flexion deformity of the hip

Question 4

What does Schober’s test indicate?

Answer 4

Schober’s test for lumbar spine

Question 5

What is GALS

- components of exams

Answer 5

GALS (Gait, Arms, Legs Spine)

To allow a rapid screening examination of joints

• Assess gait & turning quickly
• Lateral flexion of cervical spine
• examine from the side of back
• touch toes for hip/lumbar flexion (Schober’s test)
• full shoulder abduction/external rotation
• inspect swelling/deformity of wrists & hands
• palms for muscle bulk
• power grip, fine precision pinch test
• squeeze MCPs

On the examination couch:

• full knee flexion & internal rotation of hip in flexion
• Patellar tap
• squeeze MTPs of feet