Exam

Question 1

Thompson test

Answer 1

with patient prone and knee flexed and ankle over exam table, squeeze calf, ankle should plantarflex

Question 2

Trigger finger

How do you test and how do you inject

Answer 2

Have him/her grasp finger, then relax other fingers. The affected finger will lock or pop when opens.

May inject, but no more than 2cc (2.5mg of Kenalog and 1/2cc of Xylocaine)

Question 3

DeQuervain’s tenosynovitis

Where does it hurt, how do you test for it, and how do you inject

Answer 3

Pain is over radial side of wrist.

Trigger by Finkelstein’s test - put thumb in palm and ulnarly deviate.

May inject, but no more than 2cc (2.5mg of Kenalog and 1/2cc of Xylocaine) into tendon sheath

Question 4

Durkin’s compression test

How do you do it, and what does it test for?

Answer 4

sl. flex wrists and press on median nerve - should hurt within 15 seconds

Tests for CTS

Question 5

Cubital tunnel syndrome

How does it present, what 3 things are done in the exam, and where do you inject

Answer 5

Numbness in 1/2 of 4th and 5th finger (ulnar nerve)

Worse with elbow flexion, check for finger opposition. Check with compression of ulnar nerve at elbow

May inject at ulnar elbow

Question 6

Femoroacetabular impingement

What is the maneuver to test for this
What other test is positive in this

Answer 6

FADIR - Flexion, Adduction, and Internal rotation (circumduction test)
Stinchfield test - indicates joint pathology - resist hip flexion while doing supine straight leg raise

Question 7

Iliotibial band inflammation

What are the 4 tests for this

Answer 7

Thomas test - sit on edge of table so hip extends, then flex knee and adduct

Ober test - lying on side, maximally extend hip, flex knee, and let knee drop to table

Bicycle test - lying on side, do bicycle motion while feeling greater trochanter

Resisted external derotation test - While lying on back, the hip is passively flexed to 90 degrees, then externally rotated. Patient tries to return the leg to neutral against the examiner’s resisting hand.

Question 8

Iliopsoas inflammation and SI joint inflammation

What is the test for this

Answer 8

FABER (Patrick’s test) - flexion, abduction, external rotation (put ankle on knee and press down on knee)

Question 9

Trochanteric bursitis

What are the 4 presenting signs

Answer 9

Pain over lateral hip, worst 1st thing in AM, better after a few steps, unable to lie on affected side

Question 10

What is the McMurray test, and for what does it test

Answer 10

Test for MCL/LCL dysfunction. Fully flex knee, externally rotate ankle, and apply valgus force. Then internally rotate ankle and apply varus force

Question 11

What is the Apley maneuver, and for what does it test

Answer 11

Tests for meniscal injury. While patient is supine, flex knee to 90 degrees, distract leg and internally and externally rotate ankle (should be pain free). Then axially load tibia and repeat ankle movements (will hurt if meniscus injured)

Question 12

What is the Thessali test, and for what does it test

Answer 12

Tests for meniscus injury. Stand on one foot, flex knee to 20 degrees, then internally and externally rotate knee

Question 13

At what degrees should varus/valgus stress be tested

Answer 13

should be done at 0 degrees and 20 degrees

Question 14

What are the 3 presenting signs of Patellofemoral Syndrome (patellofemoral chondromalacia)

Answer 14

anterior knee pain with prolonged sitting (“theater sign”)
pain with going down stairs
patellar crepitus (esp. with resisted extension).

Question 15

How is the patellar apprehension test performed

Answer 15

with knee at 30 degree flexion, push laterally gently. If patient feels may dislocate, test is positive – seen in patellar instability.

Question 16

What is a Hill-Sachs fracture and what is a Bankart fracture

Answer 16

Hill-Sachs fracture - chip fracture of humeral head after anterior dislocation

Bankart fracture - fracture of glenoid labrum at 3-6 o’clock after anterior dislocation

Question 17

What is Jobe test and what does it test for

Answer 17

Is for supraspinatus - should be done at 20-30 degrees abduction

Question 18

What does resisted external rotation test for

Answer 18

Is for infraspinatus/teres minor

Question 19

What is the shrug sign

Answer 19

It’s when patient shrugs hurt shoulder to help with abduction

Question 20

What is the modified Neer test, and what does it test for

Answer 20

In Jobe test position, then fully flex elbow, then fully flex shoulder. Tests for impingement.

Question 21

What is the Hawkins test and what does it test for

Answer 21

do modified Neer test, then move flexed elbow over forehead. Tests for impingement.

Question 22

What is the O’Brien’s test and what does it test for

Answer 22

Tests for SLAP lesion (superior labral tear). Is in Jobe position, but done with no abduction

Question 23

What do the belly press and lift-off test for

Answer 23

subscapularis injury

Question 24

What is the Speed test and what does it test for

Answer 24

is for biceps. Do with shoulders flexed to 90 degrees, palms up, then resist flexion

Question 25

What is the Yergason’s test and what does it test for

Answer 25

Is for biceps. Do with elbow flexed and at side, hand pronated, have patient abduct and supinate against resistance while palpating biceps groove

Question 26

What are the 2 tests for glenohumeral instability

Answer 26

Sulcus sign - pull down on arm at side, watch for space opening at shoulder

Apprehension test - abduct shoulder to 90 degrees, then externally rotate

Question 27

How do test for AC joint arthritis

Answer 27

Arm adducted across body will cause pain

Question 28

Hoffman’s sign

Answer 28

Thumb adduction and flexion with flicking of distal tip of 3rd finger

Question 29

Lhermitte sign

Answer 29

Electric shock down spine and into arms with neck flexion or extension

Question 30

Spurling test

Answer 30

Passively move neck to lateral flexion and extension, then gently axially compress head, will cause pain down ipsilateral arm

Question 31

Upper limb tension test

Answer 31

Patient supine and shoulder at side, while examiner at head of patient, depress shoulder and abduct to 90 degrees, then extend elbow and fingers, then maximally supinate/extend wrist. Have patient bend neck to left and right. Positive is pain at any step.

Question 32

What is the test for the Piriformis syndrome?

Answer 32

Seated piriformis stretch test - Patient seated with 90 degrees of hip flexion. The examiner extends the knee and passively moves the hip into adduction and internal rotation while palpating just lateral to the ischium. Positive test is pain.

Question 33

What is ischiofemoral impingement, and what is the test for it?

Answer 33

It is impingement of the quadratus femoris muscle and nerve between the proximal femur at the level of the lesser trochanter and the ischial tuberosity.

Long-stride walking test - The patient takes a long step on the unaffected leg with the hip pointed forward. Positive test is pain in buttock.