Ankle

Question 1

Anterior drawer test (ankle)

Answer 1

Grasp posterior calcaneus with one hand and distal
tibia/fibula with the other hand, monitoring anteriorly at the anterior talus. Provide anterior force on calcaneus while stabilizing the distal tibia/fibula. Normal springing of calcaneus back to neutral should occur.

Tests for ATF path (lateral ankle sprain)

Question 2

Talar tilt test

Answer 2

Grasp distal tib/fib with one hand and inferior calcaneus with the other, blocking motion of the calcaneus on the talus. Invert the talus to evaluate ROM.

(+) test = laxity, increased ROM or pain

Tests for calcaneofibular ligament pathology/tear and some ATF (lateral ankle sprain)

Question 3

Eversion test

Answer 3

Grasp distal tib/fib with one hand and plantar surface of the mid-foot with the other hand. Evert the foot to evaluate ROM.

(+) test = laxity, increased ROM or pain

Tests for deltoid ligament pathology (medial ankle sprain)

Question 4

Squeeze test

Answer 4

Wrap hands around leg proximal to ankle, contacting distal tibia/fibula with both thenar eminences. Squeeze for 2-3 seconds, then rapidly release.

(+) test = pain at syndesmosis

Tests for syndesmosis pathology (high ankle sprain)

Question 5

Cross leg test

Answer 5

Patient crosses affected ankle over opposite knee. Apply pressure to proximal fibula of affected leg.

(+) test = pain at distal ankle

Tests for syndesmosis pathology (high ankle sprain)

Question 6

Thompson test

Answer 6

Pt prone with foot off the table. Squeeze the pt’s calf. The foot should plantar flex.

(+) test = absence of plantar flexion

Tests for Achilles tendon rupture

Question 7

Homan’s sign

Answer 7

Pt laying or seated with knee extended. Dorsiflex the patient’s foot. Lateral compression of the calf may also be added.

(+) test = pain with dorsiflexion

Indicates thrombophlebitis or acute deep venous thrombosis (DVT), especially in the setting of edema, erythema, and warmth of the lower leg.
Need to get a Venous Doppler to rule out clot. (Not always performed clinically due to potential risk of embolus)

Question 8

Moses sign

Answer 8

Pt seated or supine. Induce an anterior compression on the gastrocnemius muscle into the posterior aspect of the tibia (compresses the calf towards the tibia).

(+) test = pain with anterior compression

Indicates deep vein thrombosis of the posterior tibial veins (Not always performed clinically due to potential risk of embolus)