EXAMS ONLY Lower limb exam special tests Flashcards
What are the 5 back/spine exam special tests?
Schober’s test
Lasegue’s test (straight leg raise test) and Bragard’s test
Cross SLR test
Femoral stretch test
Schober’s test:
- How to perform it?
- What is a positive and negative test?
Get patient to stand up
Palpate the midpoint between the PSIS.
Measure 10cm above.
Ask patient to lean forward
Measure new distance between these two points
Positive test: <5cm difference
Negative testL >= 5cm difference
Schober’s test:
- Common reason for positive sign? And less common reason?
Muscle trauma
Anklyosing spondylytis
What is the most common cause of sciatica?
Disc herniation
Straight leg raise test/Lasegue’s test
- How to perform it?
- What are positive and negative signs?
- Is pain associated with muscle stretching a positive sign?
Lie patient supine.
Passively raise patient’s AFFECTED leg straight to around 70 degrees.
Positive sign: pain (in buttock, may shoot down to foot).
Negative sign: no pain
NO
Bragard’s test
- When is it performed, and why?
- How to perform it?
- Positive and negative signs?
When there is a positive Lasegue’s test. To see if it’s a true or false positive.
Passively lower the patient’s straight leg slightly, until pain goes.
Then, dorsiflex the foot - see if the pain reappears
Positive sign: pain reappears
Cross straight leg test
- How to perform?
- Positive and negative signs?
As per SLT, EXCEPT the unaffected leg is lifted.
Positive sign: sciatic pain in unlifted leg
How to remember sensitive vs specific?
Of the straight leg test (Lasegue’s) and cross straight leg test, which one is:
- Sensitive but not specific?
- Specific but not sensitive?
SPPIN SNOUT
- Specific is true positive, rule in
- Sensitive is true negative, rule out
Lasegue’s is sensitive, not specific (false positives due tomuscle pain)
Cross straight leg raise test is specific, not sensitive
Femoral stretch test:
- How to perform?
- Positive sign?
Passively flex the patient’s knee to 90*, then left their thigh.
Positive sign: anterior thigh pain
What are the 2 special tests for the hip?
What are the 2 measurements of the hip?
Trendelenburg test
Thomas test
True and apparent length
Trendelenburg test
- Is assesses weakness of which 2 muscles? What is their ordinary role?
- What MSK condition may be causing this weakness?
Gluteus medius and minimus - hip abductors, maintains centre of gravity
Arthritis
Trendelenburg test
- How to perform
- Positive and negative sign?
Get patient to stand on one leg, can use wall for support.
Negative sign: hips level
Positive sign: pelvis drops towards lifted leg.
Thomas test
- Assesses the range of motion in which muscle?
-Which may be limited in which condition?
Iliopsoas
Arthritis
Thomas test
- How to perform?
- Positive and negative signs?
Get patient to lie on bed, bring knee to chest (hip flexion)
Positive sign: back or straight knee lifts off the ground
How to measure true vs apparent leg length?
From medial malleolus to ASIS/umbilicus
Patellar tap test:
- What does it test for?
- How to perform?
- Positive sign?
Bulge sign:
- What does it test for?
- How to perform?
- Positive sign?
Patellar apprehension test
- What does it test for?
- How to perform?
- Positive sign?
Lateral collateral ligament: varus stress test
- How to perform?
- Positive sign?
Medial collateral ligament: valgus stress test
- How to perform?
- Positive sign?
Anterior cruciate ligament: anterior drawer test
- How to perform?
- Positive sign?
Anterior cruciate ligament: Lachmann test
- How to perform?
- Positive sign?
Posterior cruciate ligament: posterior draw test
- How to perform?
- Positive sign?
McMurray’s test:
- What does it test for?
- How to perform?
- Positive sign?
Thessaly’s test
- What is it?
- How to perform?
- Positive sign?
