Knee Special Tests

Question 1

Anterior Drawer test

Answer 1

ACL injury
Supine with knee flexed to 90* and the hip flexed to 45 degrees, and apply anteriorly directed force to the tibia on the femur, palpating the tibial plateau.

Question 2

Lachman test

Answer 2

ACL injury
Patient in supine with knee flexed 20-30 degrees. Therapist stabilizes the distal femur with one hand and applies anterior directed force to the tibia with the other hand.

Question 3

Lateral pivot shift test

Answer 3

Rotary Instability (MCL, ACL)
pt in supine, hip flexed and abducted to 30 degrees with slight medial rotation. Laterally rotate tibia and apply valgus force to knee while knee is slowly flexed. 
Positive = shift or clunk between 20 and 40 degrees of flexion

Question 4

Posterior drawer test

Answer 4

PCL injury
supine with knee flexed to 90 degrees and hip flexed to 45 degrees and apply posteriorly directed force to the tibia on the femur, palpating the tibial plateau.

Question 5

Posterior sag sign

Answer 5

PCL injury
supine with knee flexed to 90 degrees and the hip flexed to 45 degrees.
Positive = tibia sagging backward on the femur

Question 6

Slocum test

Answer 6

ACL injury
supine with knee flexed to 90 degrees and hip flexed to 45 degrees, rotate foot 30 degrees medially (or 15 degrees laterally) and perform anterior drawer test.

Question 7

Valgus Stress Test

Answer 7

MCL, PCL, POL injury

supine and knee flexed 20-30 degrees, and apply valgus force to lateral side of the knee

Question 8

Varus Stress Test

Answer 8

LCL, PCL, arcuate complex

supine and knee flexed 20-30 degrees, and apply varus force to the medial knee

Question 9

Apley’s compression test

Answer 9

Meniscal lesion
prone with knee flexed 90 degrees. With hand on pt’s heel, medially and laterally rotate tibia while apply compressive force through tibia.

Question 10

Bounce home test

Answer 10

Meniscal lesion
supine, maximally flex knee and passively extend knee.
Positive = incomplete extension or a rubbery end feel

Question 11

McMurray Test

Answer 11

Meniscal lesion
supine, palpate knee joint and hold heel. With knee fully flexed, medially/laterally rotate tibia and extend the knee
Positive = crepitation over joint line

Question 12

Thessaly test

Answer 12

Meniscal tear
Standing with 1 leg in 5 degrees of flexion, rotating the femur on tibia laterally and medially three times. PT helps to maintain balance.

Question 13

Brush Test

Answer 13

Effusion of the knee
supine, place hand below joint line on medial surface of patella and stroke proximally with the palm and fingers, while the other hand strokes distally on the lateral surface.
Positive = visual wave of fluid below the medial distal border of the patella

Question 14

Patellar tap test

Answer 14

Effusion of the knee
supine, with knee flexed or extended to a point of discomfort. Apply slight tap over the patella
Positive = if patella appears to be floating

Question 15

Clarke’s sign

Answer 15

Patellofemoral dysfunction
supine with knees extended, apply slight pressure distally to the superior patella and ask pt to contract quads
Positive = unable to contract without pain

Question 16

Hughston’s Plica Test

Answer 16

supine, flex and medially rotate tibia, move patella medially and palpate the medial femoral condyle
Positive = popping sound over medial plica while knee is passively flexed and extended

Question 17

Noble compression test

Answer 17

ITB friction syndrome
supine, hip slightly flexed and the knee flexed 90 degrees. Apply pressure to lateral epicondyle while patient slowly extends knee.
Positive - pain over the lateral femoral epicondyle at approximately 30 degrees

Question 18

Patellar apprehension test

Answer 18

Patella subluxation or dislocation
supine, knees extended. Places both thumbs on the medial border of the patella and apply laterally directed force
Positive = look of apprehension of quad contraction to avoid subluxation