Orthopedic tests for OSCE : shoulder, elbow, wrist, hip, pelvis Flashcards
knowledge of the OSCE test components for 2nd year Osteopathy exam at SCU (101 cards)
1
Q
Shoulder: Describe The Neer Impingement test
A
- Pt is seated or standing
- elbow extended, Shoulder is taken into internal rotation
- Shoulder is abducted to 180 d
2
Q
Shoulder: what is a positive for the Active Compression test of O’Brien?
A
If the patient reports pain on internal rotation but this is eliminated/reduced external rotation
3
Q
Shoulder: What does the Sulcus Sign test for?
A
Laxity in G H joint
4
Q
Describe the Apprehension (Crank) test
A
1) The patient is lying supine on the treatment table.
2) The practitioner takes the patient’s shoulder into abduction and slowly introduces external
rotation. This is best achieved by supporting the upper limb at the flexed elbow with one
hand and at the wrist with the other hand.
- This test MUST be done slowly. If there is instability and the test is done too quickly the
humerus may dislocate.
5
Q
Shoulder: what is the goal of the Apprehension (crank test)?
A
It shows Global instability of G H joint
6
Q
Shoulder: Describe the Jobe Relocation and Surprise Test
A
- Pt Supine
- 90 deg abduction
- Slow external rot’n
- Apply posterior trans force to the head of the humerus
- Sudden release of posterior pressure
7
Q
Shoulder: describe the Jerk test
A
1) The patient is seated on the treatment table.
2) The practitioner takes the involved upper limb of the patient and passively flexes the shoulder to 90 degrees with the elbow bent to 90 degrees.
3) The practitioner then grasps around the elbow and applies an axial load through the humerus in a posterior direction.
4) This axial load is maintained while the practitioner adducts the arm across the patient’s body. A sudden ‘jerk’ or shift may occur, indicating translation of the humeral head on the
glenoid.
5) The practitioner releases the load and abducts the arm back toward the starting position. If a shift of the humeral head occurred previously the practitioner may observe a ‘relocation’ of
the humeral head in the form of a second ‘jerk’ as the arm is returned to this position.
8
Q
Shoulder describe the sulcus sign
A
Purpose
This test is used to assess for laxity in the glenohumeral joint
Procedure
1) The patient is seated or standing with the arm to be tested relaxed by the side in neutral
2) The practitioner grasps the patient’s forearm just below the elbow and applies a traction force inferiorly.
Interpretation
The presence of a sulcus in the subacromial region of the shoulder may indicate glenohumeral joint laxity, or instability in the inferior region of the glenohumeral joint.
9
Q
Shoulder: What is a positive sign of the Jerk test?
A
translation of humeral head on G H joint may show “clunk” or jerk on adduction or abduction (return) of arm
10
Q
Shoulder: Describe the Hawkins-Kennedy test
A
- Pt is seated
- Arm is flexed & elbow flexed at 90
- Clinician arm is under pt arm and placed on the shoulder
- Clinician internally rotates patient shoulder via the wrist.
11
Q
Shoulder: Describe the horizontal Adduction test
A
This test is used to assess for acromioclavicular joint pain
Procedure
1) The patient is standing or sitting
2) The patient’s upper limb is taken across the body (reaching the hand to the opposite shoulder) as far as possible.
Interpretation
This test is considered positive if the patient reports pain localised around the acromioclavicular joint
12
Q
Shoulder: What does the Horizontal Adduction test find?
A
Acromioclavicular joint pain
13
Q
Shoulder: Describe Hornblowers Sign Test
A
- Pt sitting. Clinician behind and side
- Shoulder adducted 90d in scapular plane and elbow flexed 90d
- Pt moves arm into external rotation against resistance
14
Q
Shoulder: Describe the Active Compression of O’Brien test
A
1) The patient is standing in front of the practitioner
2) The practitioner takes the patient’s shoulder to 90 degrees of flexion with the elbow fully extended.
3) The shoulder is adducted 10-15 degrees and medially rotated (so the thumb ends up pointing downward).
4) The practitioner stands behind the patient and applies a downward force to the patient’s upper limb and the patient resists the force.
5) The pressure is released and the patient’s arm is returned to the starting position but the shoulder is taken into external rotation instead.
6) The practitioner then applies a downward force once again while the patient resists.
15
Q
Shoulder: Describe the empty can test
A
1) The patient is seated or standing in front of the patient.
2) The patient’s shoulders are taken into abduction at 90 degrees in the scapular plane (with the elbows extended).
3) The shoulders are medially rotated so the thumb is pointing down.
4) The practitioner applies a downward force over the patient’s distal forearm while the patient resists the force.
16
Q
Shoulder: What is a positive sign in the Empty Can (Jobe) Test?
A
Patient reports pain in shoulder, or there is asymmetrical weakness
17
Q
Shoulder: Describe the external rotation lag sign test
A
1) The patient is seated or standing in front of the practitioner.
2) The patient’s shoulder is taken into approximately 90 degrees of abduction with the elbow flexed to 90 degrees.
3) The practitioner takes the patient’s arm toward maximum external rotation and the patient is asked to hold that position.
18
Q
Shoulder: What does the External Rotation Lag Sign Test find?
A
Rotator cuff tear (supraspinatus or infraspinatus)
19
Q
Shoulder: Describe the Lift Off (Gerber’s) test
A
1) The patient is standing in front of the practitioner
2) The patient is asked to place their hand on their back pocket or mid-lumbar.
3) The patient is then asked to ‘lift’ the hand away from the pocket/lumbar.
4) If the patient is able to lift the hand away then the practitioner applies a resistance to the hand attempting to ‘push’ it back toward the pocket or lumbar.
20
Q
Shoulder: What is a positive sign for the Lift Off (Gerbers) Test
A
unable to lift the hand away from the pocket/lumbar.
The application of pressure back on the patient’s hand is to examine the strength of the subscapularis muscle and how the scapula acts under loading.
21
Q
Shoulder: Describe the Painful Arc Sign test
A
- The patient is standing in front of the practitioner
- the patient is asked to abduct the arms in the coronal (frontal) plane toward end rang
22
Q
Shoulder: Describe the Drop Arm Test. What is it testing?
A
- The patient is standing
- clinician elevates the upper limb to 90 degrees of glenohumeral abduction
- the patient takes the weight of the limb
a full-thickness tear in the rotator cuff
23
Q
Shoulder: Describe the infraspinatus Muscle test
A
- The patient is sitting
- elbow flex to 90 degrees
- the patient is asked to push out against resistance
24
Q
Shoulder: Describe Speeds Test.
A
- The patient is standing.
- The patient is asked to extend the elbow and supinate the forearm
- The patient flexes the shoulder to 90 degrees against resistance
25
Shoulder: Describe the Biceps load Test (Kim Test II)
1) The patient is lying supine on the treatment table
2) The patient’s shoulder is taken into 120 degrees of shoulder abduction
3) The patient’s elbow is then flexed to 90 degrees
4) The patient is asked to flex the elbow whilst the practitioner resists this movement
26
Shoulder: What is a positive sign for the Biceps load Test (Kim tests II)?
the patient reports pain at the anterior shoulder around the region of the long head biceps tendon. If pain or apprehension occur with the external rotation alone this may indicate instability in the glenohumeral joint.
27
Shoulder: Describe the nature of the Acromioclavicular Joint pain Cluster
Purpose
There are two clusters available for examining the likelihood of the acromioclavicular joint as a source of the patient’s pain.
Paxino’s sign
Procedure
1) The patient is seated on the treatment table with the practitioner standing behind
2) The practitioner places a thumb pad over the posterior aspect of the acromion and the pad
of the index and/or middle finger of the same hand over the anterior aspect of the midportion of the clavicle.
3) The practitioner applies a shearing force by approximating the two digits
Interpretation
This test is considered positive if the patient reports pain at the acromioclavicular joint
28
Shoulder: What does a positive finding for the Acromioclavicular Joint Pain Cluster mean?
the acromioclavicular joint as a source of the patient’s pain. If both the Paxino’s sign and active compression test of O’Brien are positive there is a positive likelihood ratio of 2.71.
This test cluster has a specificity of 95.8%
29
Shoulder: If the Paxino's sign test shows negative what test should it be followed with to prove the determination?
Hawkins-Kennedy test
30
Wrist: Describe the Distal Radioulnar Joint Stability Test
* The patient is seated or standing
* The patient’s elbow is flexed to 90 degrees. The practitioner grasps around the distal ulnar (approximately 4cm proximal to the end to avoid pressing on sore structures). The other hand holds around the patient’s palm.
* The practitioner applies alternating anterior and posterior pressure to the distal ulna, allowing the bone to ‘spring back’ to the starting position with each movement. This is performed in neutral, full pronation, and full supination.
* The practitioner notes the stability of the joint indicated by the springing back of the ulna. The wrist is then radially deviated, and the movements are performed again
This result is compared to the other wrist
31
Wrist: describe the Scaphoid Compression Test
* The patient is seated or standing
* The practitioner holds the distal forearm with one hand and grasps around the patient’s thumb with the other hand.
* The practitioner applies longitudinal compression through the thumb toward the carpals.
32
Wrist: Describe the ulnomeniscotriquettral glide test
1) The patient is seated or standing.
2) The forearm is pronated and the practitioner supports the patient’s upper limb and places a
thumb on the dorsal surface of the distal ulna.
3) The index finger of the same hand is pressed on the palmar side of the pisotriquetral complex.
4) While maintaining an anterior force over the distal ulna the practitioner applies a posterior force through the index finger to introduce a shear force between the two structures.
33
Wrist: what does the Ulnomeniscotriquetral dorsal glide test for?
injury of the triangular fibrocartilage complex.
34
Wrist: Describe the Watson Test (Scaphoid Shift)
* The patient is seated beside the table, with the elbow on the side to be tested resting on the table and the forearm pronated.
* The practitioner is holding the hand on the side to be tested with one hand. The thumb on the other hand applies pressure on the scaphoid tubercle on the palmar side of the wrist to prevent anterior movement of the scaphoid during the test, while the fingers provide a counter pressure on the dorsal aspect of the forearm.
* The practitioner takes the patient’s wrist into full ulnar deviation and slight wrist extension while maintaining pressure over the scaphoid. 4) The examiner then takes the patient’s wrist into radial deviation and slight flexion while maintaining pressure on the scaphoid tubercle. 5) If the scaphoid and scapholunate joint are unstable the scaphoid will shift over the dorsal rim of the radius.
35
Wrist: What does the Finkelstein test reveal?
De Quervain’s tenosynovitis, or paratendinitis in the thumb.
36
Wrist Describe the Finkelstein test
1) The patient is asked to make a fist with the thumb inside the fingers.
2) The practitioner stabilises the forearm in one hand and holds the patient’s fist with the other hand.
3) The practitioner deviates the wrist toward the ulna
37
Wrist: Describe the carpel compression test
1) The patient’s forearm is supinated and held in the practitioner’s hands
2) The practitioner places one thumb over the other directly over the median nerve in the carpal tunnel and applies a downward pressure for 30-60 seconds.
38
Wrist: What is a positive sign for the carpal compression test?
the patient reports reproduction or worsening of symptoms in the hand (paraesthesia, numbness, pain) in the median nerve distribution.
39
Wrist: Describe the hand elevation test
The patient is asked to raise both hands over the head and maintain the position for 3 minutes.
40
Wrist: What does the hand elevation test reveal?
assess for carpal tunnel syndrome
41
Wrist: Describe Phalen's test.
The patient’s wrists are taken into full flexion, with the back of the hands pressed together and held in this position for one minute
42
Wrist: Describe the Allen test
1) The patient is asked to open and close their hand several times and then squeeze the hand tight
2) The practitioner places one thumb of each finger over the ulnar and radial arteries, compressing them.
3) The patient opens the hand while the practitioner maintains the pressure over the arteries. The practitioner then releases the pressure over one artery to test if the hand flushes and
notes the time taken for the hand to flush.
4) The process is then repeated from steps 1-3 however the other artery is tested by removing pressure from the other artery in step 3.
43
Wrist: What does the Allen test reveal?
the patency of the ulnar and radial arteries
44
Pelvis: what is the Gapping test for the pelvis?
The patient is lying supine.
The practitioner stands beside the table facing toward the patient’s head and crosses the arms to place the palmar aspect of their hands on the medial aspect of the patient’s anterior superior iliac spines (ASIS).
The practitioner then applies a lateral force ‘gapping’ the ASIS away from each other
45
Pelvis: What is the goal of the sacroiliac rocking test?
the sacroiliac joint is a likely source of the patient’s pain
46
Pelvis: Describe the Thigh Thrust
The patient is lying supine on the treatment table
The practitioner stands on the side opposite that being tested and flexes the hip on the side to be tested (with the knee flexed) and hugs the knee toward their chest.
The practitioner reaches under the patient’s pelvis and places their hand across the sacrum.
Using their body the practitioner thrusts down through the table to create a shear force between the sacrum and the ilium.
47
Pelvis: What is a positive outcome for the Gaeslen test?
the patient reports pain in the sacroiliac joint region
48
Pelvis: What is the goal of the Yeoman's test?
This test is used to assess for the source of the patient’s pain between the lumbar spine, sacroiliac joint, and femoral nerve
49
Pelvis: Describe the sacral thrust test
The patient is lying prone on the treatment table
The practitioner places the base of their hand over the apex of the sacrum and applies firm pressure in a cranial direction
50
Pelvis: What is a positive outcome for the Approximation Test?
the patient reports pain around the sacroiliac joint when pressure is applied.
51
Pelvis: What is the goal of the Flamingo test?
assess for sacroiliac joint or symphysis pubis pain
52
Pelvis: What is a positive sign in the Cluster of Laslett?
If 2 or more of the four tests are positive it can be assumed the sacroiliac joint (on the side pain is reproduced) is a likely source of the pain
53
Elbow: Describe testing the lateral collateral ligament with the varus and valgus instability tests
The patient is standing, seated, or supine on the treatment table.
2) The practitioner stands inside the patient’s upper limb and cups underneath the patient’s elbow with the hand closest to the patient. The palm rests over the medial joint line and the fingertips palpate over the lateral collateral ligament region.
3) The other hand holds the distal forearm.
4) With the elbow slightly flexed (approximately 30 degrees) the practitioner applies a varus force to the patient’s elbow by pushing laterally with the hand on the elbow and medially with the hand on the distal forearm.
54
Elbow: Describe testing the medial collateral ligament with the varus and valgus instability tests
1) The patient is standing, seated, or supine on the treatment table.
Testing the lateral collateral ligament:
2) The practitioner stands outside of the patient’s upper limb facing the patient and cups underneath the patient’s elbow with the cephalad hand. The palm rests over the lateral jointline and the fingertips palpate over the medial collateral ligament region.
2) The caudad hand grasps around the distal forearm.
3) With the elbow slightly flexed (approximately 30 degrees) the practitioner applies a valgus force to the patient’s elbow by pushing medially at the elbow joint and pulling laterally at the distal forearm.
55
Elbow: What is the purpose of the Varus and valgus instability tests?
This test is used to assess for laxity at the elbow (both medial and lateral) due to potential injury or rupture of collateral ligaments of the elbow
56
Elbow: What is a positive sign for the Varus and valgus instability tests?
The test is considered positive if the patient reports pain at the joint line or ligament under the fingertips at the elbow, or if laxity of noted in the elbow during the test compared to the other side.
57
Elbow: Describe the Hook Test
1) The patient is seated or standing
2) The patient is asked to actively flex the elbow to 90 degrees and fully supinate the forearm.
3) The practitioner then uses the index finger of one hand to ‘hook’ behind the distal biceps tendon and pull it vigorously in an anterior direction.
58
Elbow: What is the purpose of the Hook test?
This test is used to assess for potential rupture of the distal biceps tendon
59
Elbow: What is a positive finding of the Hook test?
This test is considered positive if there is no resistance to the anterior force applied by the finger.
Pain may also be produced in this test.
60
Elbow: Describe the Mills Test
1) The patient is seated or standing
2) The practitioner supports the patient’s elbow in one hand by cupping underneath the elbow
with the thumb resting over the lateral epicondyle. The other hand holds the patient’s hand.
3) The patient is asked to make a fist and the practitioner holds the fist closed with their hand.
4) The practitioner then fully flexes the wrist and hand, pronates the forearm and fully extends the elbow while maintaining the wrist in the flexed position.
61
Elbow: What is the purpose of the Mills Test?
This test is designed to assess for lateral elbow pain originating from structures attaching to the lateral epicondyle of the humerus.
62
Elbow: What is a positive sign of the Mills Test?
This test is considered positive if the patient reports reproduction or worsening of pain at the lateral epicondyle. This may indicate lateral epicondylitis or injury to the extensor tissues of the wrist/hand.
63
Elbow: Describe the Cozen's Test
1) The patient is seated or standing
2) The practitioner supports the patient’s elbow in one hand by cupping underneath the elbow with the thumb resting over the lateral epicondyle. The other hand holds the patient’s hand.
3) The patient is asked to make a fist and the forearm is pronated and the wrist is radially deviated.
4) The patient’s wrist is then taken into extension (maintaining the other positions) and from here the patient is asked to resist as the practitioner attempts to flex the patient’s wrist.
64
Elbow: What is the purpose of the Cozen's Test
This test is designed to assess for lateral elbow pain originating from structures attaching to the lateral epicondyle of the humerus.
65
Elbow: What is a positive finding of the Cozen's Test?
This test is considered positive if the patient reports reproduction or worsening of pain at the lateral epicondyle. This may indicate lateral epicondylitis or injury to the extensor tissues of the wrist/hand
66
Elbow: Describe the Elbow Flexion test
The patient is asked to flex the elbow fully with the wrist fully extended and the shoulders abducted to 90 degrees, and the scapulae depressed.
2) This position is held for 3-5 minutes
67
Elbow: What is the purpose of the Elbow Flexion Test?
This test is used to assess for potential cubital tunnel syndrome.
68
Elbow: What is a positive finding of the Elbow Flexion Test?
This test is considered positive if the patient reports reproduction of tingling, numbness, or paraesthesia in the ulnar nerve distribution of the forearm and hand.
69
Elbow: Describe the Pinch Grip test
The patient is asked to pinch the tips of the index finger and thumb together (making an ‘OK’ sign).
70
Elbow: What is the purpose of the Pinch Grip Test?
This test is used to assess for potential anterior interosseous nerve or ulnar nerve pathology.
71
Elbow: What is a positive finding of the Pinch Grip Test?
If the patient is unable to achieve tip-to-tip pinch and instead finger pad to thumb pad this may indicate pathology of the anterior interosseous nerve.
If there is hyperextension of the metacarpophalangeal joint of the thumb this may indicate pathology of the ulnar nerve, affecting the adductor pollicus muscle.
72
Hip: Describe the hip scour test
1) The patient is lying supine on the treatment table.
2) The practitioner flexes and adducts the patient’s hip so that the patient’s knee is pointing to the patient’s opposite shoulder.
3) Slight compression is maintained as the patient’s hip is taken into abduction, with the practitioner maintaining the hip in flexion. The motion is in an arc from adduction toward abduction
73
Hip: What is the purpose of the hip scour test?
This test is used to assess for potential femoroacetabular impingement or impingement of hip flexor or adductor muscles
74
Hip: What is the interpretation of a positive sign of the hip scour test?
The test is considered positive if the patient reports pain throughout the movement. Depending on what position the pain was reproduced the practitioner may be able to narrow down the possible site of impingement.
75
Hip: Describe Patrick's test
1) The patient is lying supine on the treatment table
2) The practitioner takes the patient’s lower limb on the side to be tested and flexes the hip and knee, resting the foot/ankle on top of the knee of the opposite limb.
3) The practitioner then lowers the knee on the test side and then gently applies downward pressure on the knee.
76
Hip: What is the purpose of Patrick's test?
This test is used to assess for the potential cause of the patient’s hip pain
77
Hip: What is the interpretation of a positive sign of Patrick's test?
If the application of downward pressure on the knee causes lateral hip pain, superolateral and lateral femoroacetabular impingement is suspected.
If downward pressure produces groin pain It may indicate iliopsoas pathology or impingement, or anterior capsule involvement.
Posterolateral pain reproduced with downward pressure indicates potential ischiotrochanteric pain.
Posterior pelvic pain with downward pressure may indicate sacroiliac joint pain.
78
Hip: Describe the leg roll test
1) The patient is lying supine on the treatment table
2) The practitioner passively rotates the femur medially and laterally toward end range,
comparing both hips.
79
Hip: What is the purpose of the leg roll test
This test is used to assess for a potential intra-articular cause of the patient’s hip pain
80
Hip: What is the interpretation of a positive sign of the leg roll test?
This test can be used to compare the range of motion from one side to the other, as well as assess for pain during the passive motion. Pain reproduced is thought to indicate an intraarticular source. A ‘click’ during the movement is thought to indicate a potential labral tear
81
Hip: Describe the Anterior Labral Tear Test
) The patient is lying supine on the treatment table
2) The practitioner takes the patient’s hip into full flexion, lateral rotation, and adduction
82
Hip: What is the purpose of the Anterior Labral Tear Test?
This test is used to assess for potential anterosuperior impingement syndrome, anterior labral tears, and iliopsoas tendinitis.
83
Hip: What is the interpretation of a positive sign of the Anterior Labral Tear test?
The test is considered positive if the patient reports pain in the anterior hip with or without a click, or apprehension.
84
Hip: Describe the Hip Lag Sign Test
1) The patient is side-lying on the treatment table
2) The practitioner extends and medially rotates the patient’s hip, and then abducts to approximately 45 degrees abduction.
3) The patient is asked to hold the position for 10 seconds
85
Hip: What is the purpose of the Hip Lag Sign Test
This test is used to assess for potential injury to hip abductor musculature
86
Hip: What is the interpretation of a positive sign for the Hip Lag Sign Test
This test is considered positive if the patient cannot hold the position or if the medial rotation decreases (indicated by the foot dropping more than 10cm). This indicates a potential tear of the
gluteus medius.
87
Hip: Describe the 90-90 Straight Leg raising Test
1) The patient is lying supine on the treatment table
2) The patient actively flexes both hips to 90 degrees with the knees bent. The patient may grasp behind the knees to maintain 90 degrees of hip flexion.
3) The patient is asked to actively extend each knee in turn as much as possible
88
Hip: What is the purpose of the 90-90 Straight Leg raising Test?
This test is used to assess hamstring extensibility
89
Hip: What is the interpretation of a positive result of the 90-90 Straight Leg raising Test?
Knee extension within 20 degrees of full extension is said to be ‘normal’ hamstring flexibility
90
Hip: What is the cluster of Sutlive?
1) A positive hip scour test
2) Passive internal (medial) hip rotation of < or = to 25 degrees.
3) Hip pain when squatting
4) Lateral hip pain with active hip flexion
5) Pain with active hip extension
91
Hip: What is the purpose of the cluster of Sutlive?
This cluster of tests and presenting signs/symptoms can aid in the diagnosis of hip osteoarthritis in individuals with hip pain
92
Hip: What is the interpretation of a positive result of the cluster of Sutlive?
If the individual has 3 out of 5 positive items in the cluster it indicates a positive likelihood ratio of 5.2
- If 4 out of 5 items are positive it raises the likelihood ratio to 24.3
o The higher above 1 the likelihood ratio the more likely the chance of the condition/disease being present
93
Pelvis: Describe the cluster of Laslett
This cluster of tests is used to assess as to whether the sacroiliac joint is the likely source of the patient’s pain. Laslett proposes that 2 out of 4 of the following tests in the cluster are required to be
positive to diagnose a symptomatic sacroiliac joint.
Tests in Cluster
1) Gapping (distraction) test
2) Thigh thrust test
3) Compression (approximation) test
4) Sacral thrust test
94
Pelvis: describe the Flamingo Test
The patient is standing and asked to lift one foot off the ground.
a. This places greater stress through the sacroiliac joint on the stance side
95
Pelvis: describe the approximation test
1) The patient is side-lying on the treatment table. The practitioner is standing beside the patient at the level of the pelvis.
2) The practitioner places their hands overlapped on the upper part of the patient’s iliac crest.
3) The practitioner applies a downward force, pressing through the patient’s pelvis.
96
Pelvis: describe the sacral thrust test
1) The patient is lying prone on the treatment table
2) The practitioner places the base of their hand over the apex of the sacrum and applies firm pressure in a cranial direction.
97
Pelvis: describe Yeoman's test
1) The patient is lying prone on the treatment table
2) The practitioner flexes the patient’s knee to 90 degrees on the side to be tested.
3) The practitioner passively extends the hip
98
Pelvis Describe Gaeslens test
1) The patient is side-lying on the treatment table with the side to be tested on top.
2) The patient flexes the patient’s knee and hugs the leg between the arm and torso.
3) The practitioner passively extends the patient's hip while supporting the patient’s pelvis.
99
Pelvis: Describe the thigh thrust
1) The patient is lying supine on the treatment table
2) The practitioner stands on the side opposite that being tested flexes the hip on the side to be tested (with the knee flexed) and hugs the knee toward the chest.
3) The practitioner reaches under the patient’s pelvis and places their hand across the sacrum.
4) Using their body the practitioner thrusts down through the table to create a shear force between the sacrum and the ilium
100
Pelvis: Describe the sacroiliac rocking test
1) The patient is lying supine on the treatment table.
2) The practitioner takes the patient’s hip and knee into flexion (drawing the knee toward the chest) and then adducts the patient’s hip.
a. Pathology at the hip or knee preventing full range of motion or causing pain separate from what is being examined for would contraindicate this test
101
Pelvis: Describe Gapping Test
1) The patient is lying supine on the treatment table.
2) The practitioner stands beside the table facing toward the patient’s head and crosses the arms to place the palmar aspect of their hands on the medial aspect of the patient’s anterior superior iliac spines (ASIS).
3) The practitioner then applies a lateral force ‘gapping’ the ASIS away from each other.
