LE Special Tests

Question 1

dorsi in WB – ligament stress test - for inf tib/fib

Answer 1

The inf TF lig restricts splaying of the mortise during DF in WB
If Inf TF lig sprain, pt will complain of pain or pinching in the front of the ankle & will have splaying of the mortise with DF in WB

Test result: (+)ve test = sprain inf TF ligament if:

Acute phase:
-↓ pain with compression (& may have ↑ ROM because less pain) OR

• Δ > 2mm in circumference around malleoli from neutral to full DF OR

Chronic phase (chronic hypermobility/instability):

• ↓ROM when applying compression with DF in WB

Question 2

ankle - Posterior drawer test

Answer 2

-

Question 3

ankle - Anterior drawer test

Answer 3

-

Question 4

ankle - alternative anterior drawer test

Answer 4

-

Question 5

ligament stress test - ATFL

Answer 5

-

Question 6

ligament stress test - ptfl

Answer 6

-

Question 7

ligament stress test - cfl

Answer 7

-

Question 8

ligament stress test - tibionavicular

Answer 8

-

Question 9

ligament stress test - tibiotalar ant

Answer 9

-

Question 10

ligament stress test - tibiocalcanear lig

Answer 10

-

Question 11

ligament stress test - tibiotalar post

Answer 11

-

Question 12

ankle - special test - ant-lat impingement test

Answer 12

Pt sitting position

Pht

Lat hand: grasps calcaneum (fingers around calc tuberosity & thumb over ant-lat part of ankle (gutter))

Med hand: grasps forefoot to control ankle movt

1. Apply thumb pressure over the ant-lat ankle with foot in full PF (looking for pain reproduction – painful area)
2. Bring ankle in full DF without any pressure
3. Repeat ankle Full DF while applying thumb pressure over painful area

(+)ve: if pain provoked with pressure from thumb is > in DF than PF

Molloy-Bendall impingement test :94.8% sensitive 88% specific

Question 13

ankle - special test - windlass

Answer 13

Question 14

ankle - special test - homan’s sign

Answer 14

Question 15

ankle - special test - thompson’s test

Answer 15

Question 17

ankle - talar swing

Answer 17

Question 32

ankle - functional tests

Answer 32

slides 12-15

Question 33

knee - LCL stress test

Answer 33

-

Question 34

knee - MCL stress test

Answer 34

Pht: supine with leg relaxed

Pht: Facing pt

Lat hand: Lat aspect of knee (TF jt line)

Med hand: grasp ankle
Apply a valgus stress

• Full extension (hyperextension if they have it) - assessing post fibres
• 30 flexion - assessing ant structures more bc more stress on them in this position
• 90 flexion

Question 35

knee ACL stress test - anterior drawer

Answer 35

Question 36

knee ACL stress test - lachmans

Answer 36

Question 37

knee - posterior drawer test

Answer 37

Question 38

knee - posterior sag test

Answer 38

Question 39

knee - mcmurray test

Answer 39

Both McMurray’s test & joint line tenderness consistently show moderate utility in detecting & ruling out meniscal tears

Question 40

knee - thessaly test

Answer 40

Question 41

knee - apley's compression test

Answer 41

Question 42

knee - mcconnel test

Answer 42

Question 43

knee - patella apprehension test

Answer 43

Question 44

knee - stutter test

Answer 44

Question 45

Hip - dynamic stability assessment in supine

Answer 45

Question 46

Hip - dynamic stability assessment in prone

Answer 46

Question 47

Hip - anterior labral tear test

Answer 47

Question 48

Hip - posterior labral tear test

Answer 48

Question 49

hip - functional tests and observations

Answer 49

In NWB & WB, looking for - Swelling, bruising which condition? - Misalignment which condition? - Bony/joint deformity Any bump? which condition? - Atrophy which muscle? - LLD - -Weber-Barstow manoeuvre q ”True leg length - -Femoral length - -Tibial length

Question 50

hip - how to palpate femoral head (ant and post), piriformis, ITB, adductors

Answer 50

Question 51

Hip - load transfer tests

Answer 51