special test for the knee Flashcards
valgus stress test
purpose: test for integrity of MCL
pt pos.: supine
prac. pos: standing next to pt. with one hand of the distal leg and other hand on the lateral side of the knee
procedure: force is applied medially. while distant hand does external rotation on the leg. done at both 0 degrees and 30 degrees
positive: pain and/or laxity
varus stress test
purpose: test integrity of LCL
pt pos.: supine
prac. pos: standing between pt. legs with one hand on distal leg and other on medial knee
procedure: force is applied laterally. while distant hand does internal rotation on the leg. done at both 0 degrees and 30 degrees
positive: pain and/or laxity
Lachman’s test
purpose: integrity of acl
pt pos.: supine with knee flexed to 30 degrees
prac. pos: standing next to pt., one hand stabilizing anterior distal femur and other hand one the posterior proximal calf
procedure: an anterior force is applied at the calf
positive: pain and/or laxity
Lelli’s test
purpose: test ACL
pt pos.: supine with knees flexed to 20-30 degrees
prac. pos: standing next to pt., one hand as a fist under the calf belly, one hand on anterior thigh
procedure: force is applied straight down with thigh hand
positive: foot not leaving the table. normal response is foot elevating from table
pivot shift test
purpose: test ACL
pt pos.: supine
prac. pos: at side of pt. one hand on distal tibia and opposite thumb posterior to the proximal fibula head.
procedure: internal rotation is obtained by rotating the distal hand and a valgus force is applied to the knee. Knee is taken into flexion and extension while maintaining the internal rotation and valgus force
positive: pain, apprehension, and visual “clunk” at 30 degrees of flexion
anterior drawer test
purpose: ACL
pt pos.: supine with knee flexed to 90 degrees and foot on table
prac. pos: slightly Sit on foot. both hands grasping the flexed proximal tibia
procedure: making sure hamstrings are relaxed. anterior force is then applied to the proximal tibia
positive: pain and/or laxity
posterior drawer test
purpose: PCL
pt pos.: supine with knee flexed to 90 degrees and foot on table
prac. pos: slightly Sit on foot. both hands grasping the flexed proximal tibia
procedure: making sure hamstrings are relaxed. posterior force is then applied to the proximal tibia
positive: pain and/or laxity
posterior sag sign
purpose: PCL
pt pos.: supine
prac. pos: at foot of pt. with hands under both heals
procedure: pt. legs are lifted off the table and observation is made of the tibial tuberosity’s height
positive: sagging of the tibia, posterior translation
Godfrey’s test
purpose: PCL
pt pos.: supine with knee flexed to 90 degrees and hips flexed to 90 degrees
prac. pos: at foot or side of pt. supporting the feet
procedure: making sure hamstrings are relaxed. hold both heals equally
positive: sagging of tibia on the injured side
Quadriceps active test
purpose: PCL
pt pos.: supine with hips flexed to 45 degrees and knees flexed to 90 degrees, foot flat on table
prac. pos: at foot of patient, stabilizing the foot
procedure: pt is instructed to flex the quad while the practitioner holds foot in place
positive: anterior translation of the tibia on the femur as the quads pull the tibia back into place
slocum test
purpose: anterior lateral rotatory instability
pt pos.: supine with knees flexed to 90 degrees and foot stabilized on the table. tibia externally rotated
prac. pos: at foot or next to pt. both hands on posterior proximal calf
procedure: anterior force is applied through joint line. attempted to move the tibia anteriorly. exactly like anterior drawer but with foot internally rotated
positive: pain and/or laxity, rotation of the tibia
MCmurray’s test
purpose: meniscal tears
pt pos.: supine with knee Brought to test
prac. pos: standing next to pt. one hand on distal leg and one hand on joint line of knee
procedure: for
medial meniscal tears: externally rotate leg and varus stress is applied with knee extension
lateral mensical tears: internally rotate leg and valgus stress is applied with knee extension
positive: pain, snapping, popping, catching
bounce home
purpose: meniscal tear (primarily anterior side)
pt pos.: sitting or supine
prac. pos: standing at foot or next to pt. one hand on distal tibia and the other behind the knee
procedure: slight flexion (5-7 degrees) is passively obtained while supporting the leg off the table. then knee is allowed to freely drop into extension
positive: pain, inability to allow movement, apprehension
Apley’s test (compression and distraction)
purpose: meniscal tear, posterior corner of meniscus
pt pos.: prone with knee flexed to 90 degrees
prac. pos: standing next to pt. one hand on heel, the other on distal tibia (compression), one hand on distal tibia, the other stabilizing at distal hamstring (distraction)
procedure: pressure is applied through the heel while rotating tibia internally (lateral meniscus) or externally (medial meniscus)
positive: pain with compression portion that is alleviated with distraction indicates meniscal tear
Thessally
GOLD STANDARD FOR MENISCUS INJURY
purpose: meniscal tear
pt pos.: standing on symptomatic leg with hands on prac. shoulders. leg should be partially flexed (5 and 20 degrees)
prac. pos: sitting on a stool or kneeling in front of pt. with hands on hips of pt.
procedure: pt. is instructed to rotate to both sides, using the prac. for balance. Rotation is done at both 5 and 20 degrees of flexion
positive: pain, catching, clicking, or an inability to bear weight
