Valgus and Varus Stress Testing of MTP and IP Joints

Question 1

Patient Position

Answer 1

Supine or sitting

Question 2

Examiner Position

Answer 2

Standing
Proximal bone stabilized close to joint tested
Grasp bone distal to joint tested near middle of shaft

Question 3

Procedure for Valgus Testing

Answer 3

Distal bone is moved laterally, attempting to open up the joint on the medial side

Question 4

Procedure for Varus Testing

Answer 4

Distal bone is moved medially, attempting to open up the joint on the lateral side.

Question 5

Positive Test

Answer 5

Pain or increased laxity or decreased laxity when compared bilaterally

Question 6

Implications for Valgus Testing

Answer 6

MCL Sprain
Avulsion fracture
Adhesions of the involved joint

Question 7

Implications for Varus Testing

Answer 7

LCL Sprain
Avulsion fracture
Adhesions of the involved joint

Question 8

Comments

Answer 8

Increased joint laxity, especially with empty end-feel may reflect an associated fracture.