DONE: Orthopedic Tests Flashcards
listed alphabetically at first, then testing diagnosis at the end marked with ZZ.
adam’s sign
+ = scoliosis is not improved with forward flexion
structural scoliosis
adson’s test
+ = disappearance of pulse with arm outstretched 45 degrees, head rotated and extended in the same direction of arm
tight anterior scalene or cervical rib impinging on brachial artery (thoracic outlet syndrome)
anterior and posterior drawer test
+ = excessive anterior or posterior motion while pushing/pulling on foot or knee
anterior or posterior talofibular ligament injury, ACL or PCL injury
apley’s compression and distraction test
+ = pain in knee while pt is prone and force exerted from heel to knee (or pulling up on thigh) and rotated internally and externally
lateral or medial meniscal injury (or ligament injury to the collateral ligaments/sprain rupture)
apley’s scratch test
+ = pt cannot touch fingers and pain is illicited in shoulder region while trying to clasp hands behind shoulder blades
rotator cuff tear, tendonitis, weak rotator cuff
apprehension test for patellar dislocation
+ = pain or shown apprehension while doc presses patella laterally and knee in 30 deg flexion
chronic patellar dislocation
ballotable patella test
+ = patella moves down then rebounds once pressure on the patella is removed, appearance of a floating or ballotable patella
moderate - severe effusion
bechterew’s test
+ = symptoms in the back of the leg while seated with a flexed neck and extending knees alone and/or together
sciatica
bounce home test
+ = knee pain when knee falls into extension or incomplete extension while doc holds the knee flexed
meniscal tear
braggard’s test
+ = shooting pain down sciatic nerve with leg in SLR and foot in dorsiflexion
extradural sciatic nerve irritation (IV disc herniation, nerve traction injury, piriformis syndrome, SI joint dysfunction)
bulge test
+ = ripple/bulge/refilling on the lateral aspect of the knee while doc smoothes hand across medial aspect, repeat on lateral side
minor joint effusion
burns’ bench test
+ = patient is not able to perform the test or overbalances when asking to bend forward and touch the floor while kneeling on a table
malingering (also perform Hoover’s)
cervical spine compression test
+ = BL or UL pain and altered sensation while pressing straight down on pts head
nerve root compression
straight down UL = inflammation
flexion UL = compression
contralateral flexion = contraction
cervical spine distraction test
+ = pain or relief of pain while pulling up on head
pain: soft tissue injury or non-contractile tissue injury
relief of pain: nerve root impingement
cozen’s test
+ = pain over the lateral epicondyle/extensor tendon as doc applies resistance while using extensors
lateral epicondylitis (tEnnis elbow - Extensors) or extensor tendonitis
dorsiflexion test
+ = doc cannot dorsiflex the foot while knee is flexed or extended
gastroc hypertonicity if unable while knee is flexed
soleus hypertonicity if unable while knee is flexed and extended
drop arm test (codmans)
+ = arm suddenly drops at 90 degrees while adducting slowly from 180 deg
rotator cuff tear
east’s test (roos)
+ = weakness of the arm, numbness and tingling of the hand, difficult to keep arm in the position (open and closes hands BL for 3 minutes in biceps flex)
thoracic outlet syndrome - neurological or restriction of arterial flow to the arm
ely’s test
+ = hip flexion on ipsilateral side with passive knee flexion to contralateral butt
tight rectus femoris muscles, lumbar lesion, contracture of tensor fascia latae
finkelstein’s test
+ = pain in the wrist as fist with thumb inside is ulnar deviated
de Quervian tenosynovitis
forefoot adduction test
+ = foot is unable to move into neutral position while holding calcaneus with one hand and attempting to move the forefoot to medial neutral position
structural foot defect in infants
forefoot squeeze test (mortons test)
+ = pain while squeezing metatarsal heads
stress fracture or mortons neuroma
gaenslens test
+ = pain in SI area as knee of affected side is brought to chest and other leg hangs off table
SI lesion, hip pathology, L4 nerve root lesion
glenohumeral apprehension test
+ = patient feels apprehension that the shoulder might dislocate as the examiner applies pressure to posterior shoulder as arm is externally rotated in bicep flex position (NOT PAIN, they must feel apprehension)
humeral head dislocation, rotator cuff damage, detachment of joint capsule from ligaments
hawkins kennedy test
+ = pain with internal rotation as the arm is held out in front of body with elbow flexed
supraspinatus tendon or bursa are compressed/impinged
hibb’s test
+ = pain when pt is prone, knee flexed and internally rotate (heel comes out)
pain in hip = hip joint pathology
pain in butt/pelvis = SI joint lesion, unstable spinal segment
homans sign
+ = pain in the calf muscle while extending knee and dorsiflexing the foot
DVT
hoover’s test
+ = non-active leg does not press down into your palm as you ask the pt to flex the other hip
malingering
kemp’s test
+ = pain while practitioner passively moves pt into flexion, rotation, lateral flexion, and extension
local pain = facet
radiating pain = nerve root irritation, esp if pain below the knees
kernig’s test
+ = resistance and pain on passive knee extension while hip is in 90 deg flexion
meningeal irritation - meningitis, subarachnoid hemorrhage
lachman’s test
+ = excessive movement or lack of a firm end-feel while doing quick little A/P drawers on knee when in 20deg flexion
ACL injury
lindner’s test
+ = pain in cervical spine, lumbar region and leg as doc flexes pts neck in supine position
disc lesion at level of pain
lippman’s test
+ = sharp pain as doc holds patients arm flexed 90 deg and palpating biceps tendon in the bicipital groove while pronating/supinating hand
bicipital tendonitis
mcmurray’s test (reduction click
+ = snap or click with pain while medially/laterally rotating the tibia and extending the knee
- *medial rotation w + = lateral meniscus tear
- *lateral rotation w + = medial meniscal tear
milgam’s test
+ = patient cannot hold feet 2 inches off the table for > 30 seconds
disc herniation, lumbar strain, weak abd or hip flexors
mill’s test
+ = reproduction of pain at lateral epicondyle as patient uses flexors of wrist
lateral epicondylitis
minor’s sign
+ = patient shifts weight to non-painful extremity while going from sit to stand
lumbosacral involvement - sciatica, sacro-iliac lesions, lumbosacral lesions, disc involvement
nachlas’ test
+ = pain when pt is prone, knee is flexed to ipsilateral butt
pain in ipsilateral buttock or sacral area = SI disorder
pain in low back (sciatic like) = lower lumber L3/4 disorder
pain in upper lumbar area, groin or anterior thigh = tight quads or femoral nerve lesion
neer test
+ = pain as arm is in thumbs down position and doc passively brings arm up to 180 deg in the scapular plane
supraspinatus tendon impingement or tendonitis
ober’s test
+ = difficult adduction of affected knee, lateral knee pain on attempted adduction
tight, contracted, or inflamed TFL and IT band
ortalani click
+ = clunk as the femoral head relocates anteriorly into the acetabulum (abduct and externally rotate the hips)
congenital hip dislocation
patella femoral grinding test (clarks test)
+ = pain in the PFJ as doc holds space above patella and asks pt to flex quad
chondromalacia patella
patrick’s test (FABER)
+ = groin or butt pain while Flex, ABducting, and ERotatng the patients hip
SI joint pain = SI joint dysfunction, sacroiliitis
groin pain = iliopsoas strain or bursitis, intraarticular hip disorders (hip impingement/femoral acetabular impingement, hip labral tear, hip loose bodies, hip chondral lesion, hip OA)
pelvic rock test
+ = pain while compressing iliac crests toward midline
SI joint pathology
phalen’s test
+ = pain while putting dorsum of hands together and holding for 30-60 seconds
carpal tunnel syndrome
retinacular test
+ = DIP can not flex actively with or without holding the PIP straight
retinacular ligaments or capsule is tight
(if the DIP flexes while the PIP is also flexed the capsule is normal and it is just the retinacular ligament)
shoulder depression test
+ = pain of nerve roots on side being compressed as downward pressure is applied to shoulder while flexing head to opposite side
brachial plexus lesions
SLR (Lasegue’s test)
+ = pain when doc lifts pt’s leg with knee straight
<30 deg = scute spondylolisthesis, gluteal abscess, disc protrusion or extrusion, tumor, dural inflammation
30-70 deg = ipsilateral disc herniation L4-S1
soto hall test
+ = pain while pressure is applied to sternum while other hand passively lifts the head
fracture, discopathy, herniation, supraspinatous ligament tear, dural sleeve adhesions
speeds test
+ = pain in the bicipital groove as resistance is placed on arm as pt tries to abduct shoulder straight forward
bicipital tendonitis
talor tilt test
+ = stress is felt on the calcaneofibular and anterior talofibular ligaments (adduction) or deltoid ligament (abduction)
torn calcaneofibular ligament or deltoid ligament, ligamentous instability
telescoping sign
+ = excessive movement while pushing down on knee towards femur
congenital hip dislocation
test for rigid or supple flat feet
arch absent in all positions (standing, standing on toes, and seated) = rigid flat feet
arch absent only while standing = supple flat feet
thomas’ test
+ = extended leg comes off the table as the other knee is flexed into chest
tight hip flexor muscle
thompsons (squeeze) test
+ = lack of plantar flexion of the ankle while squeezing gastroc
ruptured achilles tendon
tibial torsion test
+ = angle > 18 degrees between the foot of a flexed knee (midline) and tibia
tibial torsion
tinels test
+ = tingling or shooting pain while tapping over a nerve root
carpal tunnel syndrome, ulnar nerve palsy
trendelenburg sign
+ = while standing on one leg, hip on the contralateral side of standing leg is dropping
weak glute med on standing leg
valgus and varus stress test of the elbow or knee
+ = pain in contralateral ligament while pressing on medial or lateral collateral ligament of the elbow with elbow in slight flexion
medial or lateral collateral ligament pathology
valsalva test
+ = pain in the back while valsalvaing
SOL (tumor, herniated disc)
vertebral artery test
+ = dizziness, nausea, syncope, dysarthria, dysphagia, disturbances in hearing or vision, paresis, or paralysis while the head and neck are in passive extension and side flexion, rotated to ipsilateral side and held for 30 seconds to compress blood flow
vertebrobasilar ischemia
wrights test
+ = pulses disappear when both arms are at 45 and 90 degree abduction above the head
spasm of pec minor causing compression of the brachial artery (thoracic outlet syndrome)
yeoman’s test
+ = pain as the pt is prone and the doc flexes their knee to 90 deg while also extending the hip
SI joint dysfunction
yergason’s test
+ = pain in the biceps tendon or tendon slipping out of groove as doc holds resistant force with sup/pronation
bicipital tendonitis, displaced biceps tendon, instability of biceps
ZZ. Lachmans, anterior and posterior drawer, apleys distraction and compression, medial and lateral collateral tests
medial/lateral meniscus and ACL/PCL
ZZ. positive adams
structural scoliosis
rib cage will be higher than the other when bending forward, convex side has a rib hump
Adam’s will be negative in postural scoliosis
ZZ. positive bechterews, SLR at < 70deg aggravated by dorsiflexion, braggards, kernigs
sciatica
ZZ. Positive cozen’s, mill’s
lateral epicondylitis
ZZ. positive finkelstein’s - pain in first dorsal compartment
de Quervain tenodynovitis
ZZ. positive forefoot squeeze test
mortons neuroma
ZZ. positive ober test, point tenderness of lateral femoral epicondyle, reproducible pain with knee flexion to 30deg with varus stress
iliotibial knee syndrome
ZZ. positive patellar apprehension test
patellar dislocation
ZZ. positive patellar-femoral grinding test, bounce home test
chondromalacia patella
ZZ. Positive Phalen’s and TInel’s
carpal tunnel syndrome
ZZ. positive SLR, loss of ankle reflex and/or weak plantar flexion, numbness and pain can radiate down to the sole or outside of the foot
S1 nerve root entrapment
ZZ. positive SLR, pain along front of the leg, weak extension of the leg at the knee, sensory loss about the knee, loss of knee-jerk reflex
L4 nerve root entrapment
ZZ. positive SLR, pain along side of the leg, weak extension of the big toe, numbness and pain at the top of the foot
L5 nerve root entrapment
ZZ. positive SLR, positive Kemp sign, pain not worse with valsava
spinal stenosis
ZZ. Positive speed’s, Lippman’s, Yergason’s
Biceps tendinopathy
ZZ. positive wrights, adsons, shoulder depression, easts/roos
thoracic outlet syndrome
