Knee - Special Test Flashcards
(20 cards)
Collateral Ligament Instability Test
purpose: Assess integrity of MCL and LCL - identify ligament laxity or restriction
perform: Patient supine; knee in 20-30° flexion. Apply valgus force to test MCL, varus force to test LCL.
positive: Pain or laxity = ligament injury
Lachman’s Test
purpose: ACL integrity
perform: Patient supine; knee flexed to 20-30°. Stabilize femur and pull tibia anteriorly.
positive: Soft/mushy end-feel or increased translation = ACL tear
Pivot Shift Test
purpose: ACL tear with anterolateral rotary instability
perform: Patient supine; knee extended, hip flexed and abducted slightly. Apply valgus and IR force while flexing knee.
positive: Clunk or shift around 30-40° = positive
Subluxation Test / J-sign
purpose: Lateral patellar instability
perform: Patient seated; actively extends knee from 90°. Watch for lateral tracking or jump of patella.
positive: Sudden lateral shift = positive
Posterior Sag Sign
purpose: PCL injury
perform: Patient supine; hips and knees at 90°. Observe tibial plateau alignment.
positive: Posterior displacement of tibia = PCL tear
Slocum Test
purpose: Rotary instability (anteromedial or anterolateral)
perform: Patient supine; knee flexed to 90°, hip at 45°. Foot IR (anterolateral) or ER (anteromedial); perform anterior drawer.
positive: Excessive movement = instability
Posterior Drawer
purpose: PCL integrity
perform: Patient supine; knee flexed to 90°, hip at 45°. Push tibia posteriorly.
positive: Increased posterior translation = PCL injury
Reverse Lachman
purpose: PCL integrity
perform: Patient prone; knee flexed to 30°. Stabilize femur, pull tibia posteriorly.
positive: Soft end-feel or excessive motion = PCL tear
McMurray’s Test
purpose: Meniscal tear
perform: Patient supine; fully flex knee. IR tibia + extend (lateral meniscus), ER tibia + extend (medial meniscus).
positive: Click or pain = meniscal injury
Apley’s Compression Test
purpose: Meniscal vs ligamentous lesion
perform: Patient prone; knee at 90°. Apply downward compression and rotate tibia.
positive: Pain with compression = meniscal; pain with distraction = ligament
Bounce Home Test
purpose: Meniscal tear or joint effusion
perform: Patient supine; passively allow knee to extend from flexion.
positive: Rubbery end-feel or lack of full extension = positive
Thessaly Test
purpose: Meniscal tear
perform: Patient standing on one leg, flex knee to 20°, rotate body L/R.
positive: Joint line discomfort or catching = positive
Hughston’s Plica Test
purpose: Irritated medial plica
perform: Patient supine; flex and IR tibia while moving patella medially and extending knee.
positive: Popping or pain over medial joint = positive
Patellar Apprehension Test
purpose: Patellar dislocation or instability
perform: Patient supine; knee slightly flexed. Examiner pushes patella laterally.
positive: Apprehension or quad contraction = positive
Clarke’s Sign
purpose: Patellofemoral dysfunction (chondromalacia)
perform: Patient supine with extended knee. Examiner presses above patella, asks patient to contract quad.
positive: Pain or inability to contract = positive
Ballotable Patella / Patella Tap
purpose: Indicates infrapatellar effusion
perform: Patient supine; knee extended. Compress suprapatellar pouch, tap patella.
positive: Floating or bouncing patella = effusion
Fluctuation Test
purpose: Joint effusion
perform: Patient supine; compress suprapatellar pouch, then distal patella alternately.
positive: Fluid wave = effusion
Q Angle Measurement
purpose: Assess patellofemoral alignment
perform: Patient is supine with legs extended and the lower limbs aligned at a 90° angle to the line connecting the two ASISs (anterior superior iliac spines). Draw one line from the ASIS to the midpoint of the patella. Draw a second line from the tibial tubercle to the midpoint of the patella. The angle formed by the intersection of these two lines at the patella is the Q-angle
positive: Significantly increased Q-angle may suggest abnormal patellar tracking or predisposition to knee pain (e.g., PFPS, patellar instability)
Normal Values:
Males: ~13°
Females: ~18°
Noble Compression Test
purpose: IT band friction syndrome
perform: Patient supine; knee flexed to 90°, apply pressure over lateral femoral condyle while extending knee.
positive: Pain at ~30° flexion = positive
Tinel’s Sign at Knee
purpose: Irritation of common peroneal (fibular) nerve
perform: Tap area posterior to fibular head.
positive: Tingling in lateral lower leg = positive
