extra tests Flashcards
Lachmans
What it looks for:
- considered gold standard test for ACL and PCL damage detection. Especially the posterolateral band.
Positive test:
- Pain or excessive motion of the knee. Indicates rupture of one of ACL or PCL.
- a positive sign indicates the following structures have been injured to some degree:
– ACL, PCL and Arcuate-popliteus complex
How its performed:
- pt supine, with assessing leg next to examiner.
- Hold knee between full extension and 30 degrees flexion, as this is close to the functional position of the knee (in which the ACL plays a major role).
- Pt femur stabilize with one of examiners hand, proximal aspect of tibia moved forward with the other hand.
Frank reported that to achieve the best results, the tibia should be slightly laterally rotated and the anterior tibial translation force should be applied from the posteromedial aspect.
can do a modification where examiners knee is under pt popliteus fossa, supporting knee and reinforcing that slight flexion.
Lachmans
What it looks for:
- considered gold standard test for ACL and PCL damage detection. Especially the posterolateral band.
Positive test:
- Pain or excessive motion of the knee. Indicates rupture of one of ACL or PCL.
- a positive sign indicates the following structures have been injured to some degree:
– ACL, PCL and Arcuate-popliteus complex
How its performed:
- pt supine, with assessing leg next to examiner.
- Hold knee between full extension and 30 degrees flexion, as this is close to the functional position of the knee (in which the ACL plays a major role).
- Pt femur stabilize with one of examiners hand, proximal aspect of tibia moved forward with the other hand.
Frank reported that to achieve the best results, the tibia should be slightly laterally rotated and the anterior tibial translation force should be applied from the posteromedial aspect.
can do a modification where examiners knee is under pt popliteus fossa, supporting knee and reinforcing that slight flexion.
Homans sign
what it looks for:
- DVT in the calf or ruptured bakers cyst
positive test:
- DVT or ruptured bakers cyst
- short duration deep calf pain=thrombophlebitis
- persistent achy calf pain=gastrosoleus strain
how its performed:
- pt supine with leg straight
- examiner raises pt straight leg to 10 degrees and forcefully dorsiflexes the foot
- squeeze the calf with the other hand
Thrombophlebitis- also known as ‘intravascular coagulation’ refers to inflammation and thrombosis of a vein as a result of local trauma, intravenous infusion, hypercoagulable state or damage to the endothelial lining of the veins all of which may ultimately result in venous blood stasis
Clunk test- shoulder
what it looks for:
- glenoid labral lesion
positive test:
- a clunk or grinding sound indicates a positive test and a tear of the labrum.
- test may also cause apprehension if anterior instability is present
how its performed:
- pt supine
- examiner places one hand on posterior aspect of shoulder over humeral head
- other hand holds humerus above elbow
- fully abduct pt arm over their head
- push anteriorly with hand over humeral head, while other hand rotates the humerus into lateral rotation.
Walsh indicates that if follow same maneuvers with horiz adduction, that relocates the humerus and a clunk sound might be heard indicating a tear of the labrum.
Examiner may also position the arm in different amounts of abduction (vertically ‘circling the shoulder’) and perform the test. This will stress different parts of the labrum.
Kims test- shoulder
What is looks for:
- Posteroinferior Labral lesion
positive test:
- sudden onset of posterior shoulder pain and click indicates a positive test for a posteroinferior labral lesion
how its performed:
- pt sits with back supported
- arm abducted 90 degrees with elbow supported into 90 degrees flexion.
- examiners hand, while supporting the elbow and forearm, applies an axial compression force to the glenoid through the humerus.
- while maintaining the axial compression force, the arm is elevated diagonally upward using the same hand while the other hand applies a downward and backward force to the proximal arm.
Moderate clinical value
