Special tests

Question 1

Knee to wall test

Answer 1

Tests: AROM
measures dorsiflexion in weight bearing. Place foot away from wall and lean forwards as far as possible. Measure distance between knee and wall and place finger in front of toes before swapping feet to ensure fair test.

Question 2

Anterior drawer test (ankle)

Answer 2

Tests PROM
Patient placed in prone position with ankle extending beyond bed, Talofibular joint stabilise, Heel held and anterior force applied. Positive result: excessive anterior movement of foot and dimpling of skin besides Achilles tendon.

Question 3

medial/ lateral talar tilt

Answer 3

Tests PROM
Sitting. Foot positioned in 10-20º plantarflexion, Distal leg stabilised and hind foot inverted.
Positive result: significant inversion as compared to other foot

Question 4

Squeeze test

Answer 4

Tests PROM Syndesmosis
Compression of proximal fibula against the tibia.
Positive result: pain occurs indicating fracture or diastasis.

Question 5

External rotation stress test

Answer 5

Tests PROM syndesmosis
Patient seated with knee flexed to 90º, Stabilise joint, Externally rotate foot.
Positive result: pain at site of interosseus membrane or medially.

Question 6

Shuck test

Answer 6

Tests PROM syndesmosis
Patient seated with knee flexed to 90º, Joint stabilised and hand holding calcaneus with forearm under foot, Move foot side to side.
Positive result: pain and movement of tibia and fibula within joint

Question 7

Resisted ankle eversion through range

Answer 7

Tests peroneal dislocation
Place foot in inverted, plantarflexed position. Patient should then resist eversion and dorsiflexion against physio.
Positive result: peroneus longus tendon dislocates and moves on top of lateral malleolus

Question 8

Lachman test

Answer 8

Tests ACL
place knee joint in 30° flexion, hold posterior part of tibia and use other hand to apply contrary force moving femur down and tibia/fibula up. Positive test- lots of joint movement

Question 9

Anterior drawer test (knee)

Answer 9

Tests ACL
place knee in 90° flexion, sit on foot and place hands on the back of the leg with thumbs on tibial tuberosity and pull lower leg towards you. Positive test- lots of displacement

Question 10

Posterior drawer test (knee)

Answer 10

Tests PCL
place knee in 90° flexion, sit on foot and place hands on the back of the leg with thumbs on tibial tuberosity and push lower leg towards plinth. Positive test- lots of displacement

Question 11

Sag sign

Answer 11

Tests PCL
Place knees at 90° and observe tibia in relation to femur.
If one tibia is more posterior it is a positive test- there is a sag there.

Question 12

MCL stress test

Answer 12

Tests MCL
lay patient on their back. Put your knee on plinth to anchor yourself. Grab distal part of femur and distal part of tibia. Flex leg to 30°. Push femur medial and pull tibia laterally

Question 13

LCL stress test

Answer 13

Tests LCL
A varus stress test is performed by stabilizing the femur and palpating the lateral joint line. The other hand provides a varus stress to the ankle. The test is performed at 0° and 20-30°, so the knee joint is in the closed packed position. The physiotherapist stabilize the knee with one hand, while the other hand adducts the ankle

Question 14

McMurray test

Answer 14

Tests menisci
Patient supine, flex knee to 90° for medial meniscus- medial rotation of tibia and extend the knee. For lateral meniscus, laterally rotate tibia and extend the knee. Positive result is pain and knee giving way/blocking

Question 15

Apprehension test (knee)

Answer 15

Patellofemoral test
Move patella laterally and compress. Positive test is pain

Question 16

Clarke’s sign test

Answer 16

Patellofemoral test
with one hand compress patella, glide it inferiorly and ask patient to contract

Question 17

Ober’s test

Answer 17

Iliotibial band test
Side lying with knees flexed. Hold up leg at the knee and flex to 90° drop knee and positive test of hip keeps extended but a normal test the knee will touch the plinth.

Question 18

Thomas test

Answer 18

Tests knee extensors
pt holds leg while sitting on the edge and then leans back till they’re lying down.
Positive test- hip will be flexed and may be some knee flexion.

Question 19

FABER test

Answer 19

pt supine flex knee and hip, abduct hip and externally rotate and assess for pain and where it is coming from

Question 20

FADDIR test

Answer 20

Flexion, adduction and internal rotation. Assess for pain inside the hip.

Question 21

Trendelenburg sign test

Answer 21

pt stands on one foot. Look for contralateral pelvis dropping.

Question 22

Apprehension test (shoulder)

Answer 22

Tests GHJ
Pt supine, lift arm in full range of flexion, assess apprehension of pt feeling as if joint is unstable. Perform flexion again but this time stabilise anterior shoulder.
Positive test: joint feels more stable when stabilised.

Question 23

Empty can test

Answer 23

Tests GHJ (assesses lesions of supraspinatus muscle and tendon) raise arms to 90º flexion in the scapula plane, externally rotate 45º (as if emptying cans), apply downward pressure to arms.
Positive test: pain or weakness with resistance

Question 24

Hawkins-kennedy test

Answer 24

Tests for impingement at GHJ
90º shoulder flexion, 90º elbow flexion then internal rotation of arm.
Positive test: pain when internally rotating arm.

Question 25

Scarf test

Answer 25

Tests ACJ joint integrity
90º shoulder and elbow flexion, arm horizontally adducted so rests over contralateral shoulder like a scarf.
Positive test: if reproduces pts symptoms of pain.

Question 26

Valgus/varus elbow stress test

Answer 26

Tests lateral collateral ligaments
Therapist places the patient’s elbow in slight flexion while palpating the humeroulnarjoint line.Apply a varus/valgus force to the elbow.Pain &/or laxity

Question 27

Maudsley test

Answer 27

Tests lateral epicondylitis
While palpating the lateral epicondyle, the forearm is pronated and the elbow is slightly flexed. Extension of the 3rdfinger is resisted by the examiner. Positive if pain over the lateral epicondyle

Question 28

Golfers elbow test

Answer 28

Tests medial epicondylitis
While palpating the medial epicondyle, the forearm is supinated and the elbow and wrist are extended. Positive if pain over the medial epicondyle.

Question 29

Tinel’s sign test

Answer 29

Tests nerve entrapment
the examiner percusses the ulnar nerve in the cubital tunnel for 30-60 secs while the elbow is flexed. Positive if paraesthesia/numbness down the arm.

Question 30

Mills test

Answer 30

Tests lateral epicondylitis
Pt seated and the clinician palpates the patient’s lateral epicondyle with one hand while pronating the patient’s forearm, fully flexing the wrist, the elbow extended. A production of pain in the area of the insertion at the lateral epicondyle indicates a positive test.

Question 31

Finkelstein’s test

Answer 31

Tests for de Quervain’s
Pt closes fingers over thumb and slowly moves into ulnar deviation
Positive: reproduction of symptoms

Question 32

Carpal tunnel compression test

Answer 32

Flex wrist to 60º and press between thenar and hypothenar eminence. Hold for 30 seconds.
Positive: reproduction of symptoms

Question 33

Suspected scaphoid fracture test

Answer 33

Palpate scaphoid from anatomical snuffbox. Look for pain