Special Tests Flashcards
(30 cards)
Hip quadrant test
Tests labral tear and look for clunking or pain reproduction
Patient lie supine with hip and knee flexed
SR takes hip in 90 degree flexion and then adduction
Maintain adduction and move into abduction- feel arc of movement
Can repeat test in abduction
FADIR
Patient supine
SR passively fully flex the affected hip, or to 90 degrees if P ++
Then addict hip and internally rotate
Can test hip impingement
Modified Thomas Test
Ask patient to perch at very end of couch with gluteal folds just in edge of couch
Patient should lay back to lie flat with both knees and hips flexed and clasped to chest - SR should guide and support
Ask patient to release one leg and let it hang off couch
+ = knee extends - shortness in rect fem, TFL and sartorius
Posterior thigh elevated - shortness in illiopsoas, pectineus and adductors
Abduction in thigh and lateral deviation of patella - shortness in TFL
Trendelenburg test
Patient stand on one leg
Look for any drop on the contralateral side
Modified obers test
Patient in side lying, lower leg flexed at hip and knee for stability
SR stand behind patient and passively extend and abduct their leg at the hip, and stabilise pelvis
Hip stays in ext, leg is allowed to lower to plinth
Test is modified to include ITB plus TFL
Valgus stress test
30 degrees knee flexion, SR applies valgus force
Tibial ext rotation can also be applied to bias the deep oblique fibres of the MCL
Varus stress test
SR apply Varus force in approx 25 degrees of flexion, take care of allowing any femoral rotation as stress is applied
Anterior drawer knee
Knee is passively flexed to approx 80 degrees and patients foot kept stable by SR sitting on edge of it
Ensure hamstrings are relaxed with gentle palpation
SR wraps hands around the joint line with thumbs either side of the patella apex
Anterior force applied to proximal tibia assessing increased translation
Lachmans test
Tests ACL rupture
Knee held between 15-30 degrees of flexion, one hand secured and stabilises the distal femur while other grasps proximal tibia - slightly internally rotate tibia
Gentle anterior translation force is applied to proximal tibia
Assess quality of end feel
Posterior drawer knee
Knee is passively flexed to approx 80 degrees and patients foot kept stable by SR sitting on it
Ensure hamstrings are relaxed with palpation
SR wraps hands around joint line and applies posterior force to proximal tibia to assess increased translation
Posterior sag sign
Patient lie supine with knees flexed to 90degrees
SR observed patient inured side - if posterior cruciate is torn, the tibia will appear to sag and tibial tubercle will be less prominent
Mc murrays
Knee is passively flexed, at various stages of flexion the tibia is internally and externally rotated
Pain and clicking is consistent if menisci is injured
Apleys grind
Patient prone and knee flexed 90 degrees
SR lightly secured the femur and adds compression and rotation to flexed tibia on the femur to try an elicit pain in the region of torn meniscus
Rotation is repeated with distraction
Anterior drawer ankle
Ankle is placed passively into slight plantarflexion
SR places one hand at distal end of tibia and other at heel of foot in palm of hand
Apply a force in anterior direction
Pain and laxity noted
Talar tilt
Ankle in plantarigrade the SR cups the heel and attempts to invert the ankle
Relative laxity is noted
Can be repeated with eversion
The ‘squeeze’ test
Perform a proximal 3rd compression of the tibia and fibula
Pain at site of syndesmosis implies damage
Thompson squeeze test
Patient prone with feet over edge of couch
SR squeezes calf muscle with one hand
Should cause a contraction and plantarflexion should occur
A-P glide / drawer test shoulder.
Patient seated or lying
Stand behind patient and grasp humeral head with outside hand whilst stabilising the acromion with other hand
Then move humeral head in anterior direction
Assess quality of movement
Load and shift
Patient seated or lying
SR stabilises the scapula and applied a PA force to humeral head, whilst palpating the joint line to assess degree of movement
Graded 1-3
Assess GHJ stability anterior and posteriorly
Apprehension /relocation
Patient supine with shoulder passively abducted to 90 degrees
SR adds passive external rotation
If patient displays sign of apprehension- indicate anterior instability (not pain alone)
Further confirmation with relocation test - SR applies an anteroposterior force to head of humerus - is apprehension is lessened this acts as addictions confirmation
Assess anterior shoulder instability
Sulcus sign
Patient sitting with arm resting and relaxed
Flex patients elbow and apply a downward force through the humerus
+ = gapping or sulcus sign distal to acromion
Assess inferior stability and dysfunction in GH ligaments
O’briens
Patient standing
Flex arm to 90 degrees with elbow extended then adduct arm 10-15 degrees
Arm then maximally internally rotated (thumb down) and patient resists SR downward force
Repeated in supination (thumb up)
+ = pain resisted thumb down and eliminated thumb up
Assesses superior labrum
Biceps load 2
Patient supine
SR abducts shoulder to 120 degrees with max ext rotation
Elbow flexed to 90 degrees and forearm supinated
If this position reproduces pain, perform active flexion against resistance - if pain increases = positive test
SLAP lesion tested
Speeds test
Patient elbow is extended, forearm supinated and humerus is passively elevated and humerus is passively elevated to 60 degrees
SR resists GH flexion
Detects SLAP lesion
+ = pain in bicepital groove
