Flip a coin or not? LE Flashcards
Anterior Drawer
Tests ligamentous laxity (ATFL & Ant Delt)
Meh (OK spin .73 but not great, Shitty Snout .33)
Medial Talar Tilt
Tests for ligamentous laxity of ATFL, CFL, & PTFL
Good Spin .88 worth doing to rule in
Impingement Sign
Tests for anterior ankle impingment Awesome spin (.88) and snout (.95) (DO IT)
Talocrural Impingement (CPR)
Great snout (.94) Spin (meh .75)
Syndesmosis Squeeze Test
Syndesmotic ankle sprains
Spin is awesome (.94) Rule it in
Flip a coin on snout (.30) Can’t rule it out
External Rotation Test
Tests for Syndesmotic ankle sprain
Good spin (.85)
Flip a coin for snout (Crappy .20)
Thompson Test
Tests for Achilles tendon integrity
Its going to tell you everything you need to know about the Achilles integrity
Snout .96
Spin .93
Navicular Drop
Less than 3 mm drop may indicate need for OTC orthotics
Spin good (.80)
Dont worry about snout
Ottawa Ankle Rules
Definitely can rule out a fracture, can’t rule one in
Snout .98
Spin .20
Put a tuning fork on the lat malleolus and see if it hurts (improves accuracy)
FABER
Presence of hip pathology (not specific)
Just flip a coin
Item Cluster: Hip Osteoarthritis
Identify presence of osteoarthritis in the hip (either cluster) good snout (.86) Spin ok (.75)
Hip Quadrant
Presence of hip pathology (not specific)
Snout meh (.75)
flip a coin to rule it in (.43 Spin)
FAIR test
Test for irritation or compression of sciatic nerve
I would do it
Spin .83
Snout .88
CPR: Radiographic Lumbar Instability
Detect radiographic instability
Positive if no hypomobility in vertebral segments and lumbar flexion greater than 53 when measured w/ single bubble inclinometer
Awesome Spin (.98)
Don’t even think you can rule out instability though (.29 snout)
Slump Test
Test for disc bulge or herniation
Doc Z would use it to rule out but would flip a coin to rule it in
.92 snout
.28 spin
Straight Leg Raise Test
Tests for disc bulge or herniation Good spin (.90) BAD snout (.28) Maybe add with slump test (switched snout and spin)
Slump Knee Bend Test
Tests for nerve root compression
Snout 1.00 ?? What
Spin .83 Still good
Can also test for femoral neural tension
Prone Instability Test
Tests Lumbar Instability
Not a great test by itself
Snout .72
Spin .58
Passive Lumbar Extension Test
Tests for radiographic lumbar instability
Good snout and spin (.84 snout, .83 spin)
CPR: Lumbar Manipulation
Determine likelihood that patient will respond to lumbar manip
Pretty Awesome +LR 13.2 when having 4 positive tests from CPR
-duration of current LBP 16 or less days
-No symptoms distal to knee
-FABQ work subscale 18 or less points
-Segmental hypomible in at least 1 segment
-Hip IR ROM with 1 or both hips has at least 35 degrees
Gillet Test
Tests for Sacroiliac Dysfunction
Not great by itself
Snout sucks (.43)
Spin (.68)
Supine to Long Sit
Tests for sacroiliac dysfunction
Not very reliable
Snout (.44), Spin (.64)
CPR for Sacroiliac Dysfunction
Good for ruling out .91 Snout Spin (.78) almost there -Distraction test -Thigh Thrust Test -Gaenslen Test -Compression Test -Sacral Thrust
Lachman Test
Best test for ACL integrity
Snout .85
Spin .94
Anterior Drawer Test
Can rule in an ACL can’t rule it out
Spin - .92
Snout - .55
Pivot Shift
Same as Anterior Drawer (rule in ACL, not out)
Spin .98
Snout .24 (don’t event try to rule out ACL injury)
Posterior Drawer Test
Kind of awesome for checking the PCL
Snout .9
Spin .99
Valgus Stress Test
MCL integrity
Not so great just judging on Pain
Good snout when checking laxity (.91)
Spin sucks
Varus Stress Test
LCL integrity
Don’t really know a lot about it
McMurray Test
Medial and Lateral Meniscus Integrity
Better at ruling in lateral meniscus (spin .94)
Other then that, not so good
Apley Grind Test
Medial and lateral meniscus integrity
Ok with ruling in injury spin .84
Not good at ruling out Snout .38
Thessaly .20
Best for medial and lateral meniscus integrity
Can rule in or rule out meniscus injury pretty regularly
(Spin and Snout good for both Medial and Lateral Meniscus)
Joint Line Tenderness
Better at ruling in meniscus injury (Spin .76 medial, .97 Lateral)
Not as good with ruling out (snout .83 medial, .68 lateral)
Test Item Cluster: Knee Osteoarthritis
3/6 signs Good at ruling out OA for the knee (.69) -age >50 -Stiff > 30 min -Crepitus -Bony Tenderness -Bony Enlargement -No palpable warmth
Ottawa Knee Rules
Determine if radiographs are needed Great at ruling out fracture (.99 snout) ->55 -Isolated patellar tenderness -Tenderness of fib head -Inability to flex to 90 -Inability to bear weight immediately after injury and in the emergency department (4 steps)
