Ankle SpT

Question 1

Ankle SpT’s

Answer 1

Anterior Drawer
Eversion stress test
Talar Tilt
Syndesmosis squeeze
Thompson test
Kleigers test

Question 2

Ankle: Anterior drawer procedure

Answer 2

• Patient supine
• Ankle in 20° plantarflexion
• Heel resting in the hand of examiner therefore supporting
• Examiner stabilises the tib and fib by holding it down to the bed
• Observe the amount of anterior translation and change in end feel when pulling the foot up

Question 3

Ankle: Anterior drawer purpose

Answer 3

Instability / hypermobility in saggital plane of talocrural joint

Question 4

Ankle: Anterior drawer SPEC/SENS

Answer 4

SENS: 32-80%
SPEC: 40-74%

Question 5

Ankle: Anterior drawer +ve / -ve tests

Answer 5

+ increased glide of talus
+ soft end feel
+ / - pain?
- no laxity

Question 6

Ankle: Eversion stress test procedure

Answer 6

• Patient is supine
• Knee bent at 90° and gastrocnemius relaxed
• The heel is held from below with the other hand supporting the tib and fib
• Clinician applies abduction force

Question 7

Ankle: Eversion stress test purpose

Answer 7

Integrity of deltoid ligament
Aid to determine instabilibity after a medial ankle strain

Question 8

Ankle: Eversion stress test SPEC/SENS

Answer 8

???

Question 9

Ankle: Eversion stress test +ve / -ve tests

Answer 9

+ Increased talar tilt
+ P over deltoid ligament
+ Spongy end feel could mean complete tear
- No p

Question 10

Ankle: Talar tilt procedure

Answer 10

• Patient supine with legs off bed
• Stabilise above ankle and hold the calcaneous
• Invert talus keeping tib and fib fixed

Question 11

Ankle: Talar tilt purpose

Answer 11

Injury of the anterior talofibular ligament and calcaneofibular ligament

Question 12

Ankle: Talar tilt SPEC/SENS

Answer 12

SPEC: 68-88%
SENS: 50-52%

Question 13

Ankle: Talar tilt +ve / -ve tests

Answer 13

+ 10deg more than Asx
+ P
- Less than 10deg than Asx

Question 14

Ankle: Syndesmosis squeeze procedure

Answer 14

• Long sitting
• Gently grasp tib and fib, proximal to ankle J-L
• Gently squeeze tib and fib simultaneously
• Repeat proximally just below head of fib

Question 15

Ankle: Syndesmosis squeeze purpose

Answer 15

Syndesmotic ankle sprains

Question 16

Ankle: Syndesmosis squeeze SPEC/SENS

Answer 16

SPEC: 93.5%
SENS: 30%

Question 17

Ankle: Syndesmosis squeeze +ve / -ve tests

Answer 17

+ P
+ Gapping
- No P or gapping

Question 18

Ankle: Thompson test procedure

Answer 18

• Patient prone on bed
• Gently squueze the bulk of the calf muscle

Question 19

Ankle: Thompson test purpose

Answer 19

Complete tear in achilles tendon

Question 20

Ankle: Thompson test SPEC/SENS

Answer 20

SPEC: 93%
SENS: 96%

Question 21

Ankle: Thompson test +ve -ve tests

Answer 21

+ No/minimal movement of foot into pflex
- Unusual lack of movement of foot into pflex

Question 22

Ankle: Kliegers test procedure

Answer 22

• Seated position with knee hanging at 90deg
• One hand stabilising the leg from behind
• One hand grasps the ankle in a neutral position
• Externally rotate the foot

Question 23

Ankle: Kliegers test purpose

Answer 23

Medial ankle sprain

Question 24

Ankle: Kliegers test SPEC/SENS

Answer 24

SPEC: 84.8%
SENS: 25%

Question 25

Ankle: Kliegers test +ve -ve tests

Answer 25

+ P at site of interosseous membrane or medially