Hip and Knee Special Tests Flashcards
Ely’s test
For rectus femoris contracture
- Pt prone, therapist passively flexes knee
- Positive: spontaneous hip flexion occurs simultaneously with knee flexion
Ober’s test
For ITB/ TFL contracture
- Pt sidelying, lower leg flexed at hip and knee
- Therapist moves top leg into hip ext and ABD, attempts to slowly lower that leg
- Positive: inability of test leg to adduct
Piriformis test
For piriformis tightness/ compression on sciatic nerve
- Pt sidelying, test leg up, hip flexed 60 degrees
- Therapist stabilizes pelvis and applies adducted force on the knee
- Positive: pain or tightness
Thomas test
For hip flexion contracture
- Supine, legs fully extended.
- Pt brings one knee to chest
- Therapist observes position of contralateral hip
- Positive: Straight leg rising from table
Tripod Sign
Basically slump test, but just for hamstring length not neural mobility
Positive: hamstring tightness or extension of trunk in order to limit effect of tight hamstrings
90-90 straight leg test
- Pt puts both hip/knees at 90/90
- Instructed to alternately extend each knee while maintaining hips at 90
- Positive: Knee can’t straight past 20 degrees of flexion - indicates hamstring tightness
Barlow’s test
Indicates hip dislocation being reduced (infants)
- Pt supine, hips flexed 90 degrees, knees flexed
- Move test leg into ADD while applying forward pressure posterior to great trochanter
(test legs one at a time)
Ortolani’s Test
For hip dislocation
- Pt supine, hips flexed 90 degrees, knees flexed
- Therapist grasps legs so thumbs are along patient’s medial thighs, fingers on lateral thighs toward buttocks
- Therapist adducts pt’s hips, gentle pressure applied to greater trochanters until resistance is felts at about 30 degrees.
(test both legs at once)
Anterior labral tear test (hip)
- Hip in full flexion, ER, ABD
- Therapist moves hip into ext, IR, ADD
- Positive: pain and/or click
- May also indicate iliopsoas tendinitis or anterior-superior impingement
Craig’s Test
For femoral anteversion
- Prone, knee flexed 90 degrees
- Palpate greater trochanter, IR/ER leg until treater trochanter is parallel with table
- Degree of anteversion corresponds to angle formed by lower leg with the perpendicular axis of the table.
Normal anteversion: 15 degrees
Patrick’s Test (FABER test)
For Iliopsoas, SI, or hip joint abnormalities
- Supine, start with test leg flexed, abducted, ER onto opposite leg
- Therapist slowly lowers test leg through abduction toward the table (press knee down)
- Positive: Failure of test leg to abduct below the level of the opposite leg
Quadrant scouring test
For pathologies like OA, avscular necrosis, osteochondral defect
- Supine
- Passively flex and adduct hip, knee in maximal flexion
- Apply compressive force through shaft of the femur, continue passively moving hip
- Positive: grinding, catching, crepitation
Trendelenberg Test
For Glut med weakness
- Pt stands on one leg for 10 seconds
- Positive: drop of pelvis
Anterior and posterior drawer tests (knee)
Knee flexed 90 degrees
Hip flexed 45 degrees
Lachman Test
Knee flexed 20-30 degrees
Lateral pivot shift test
- Hip flexed and ABD 30 degrees, slight IR
- IR tibia, apply valgus force to knee while knee is slowly flexed
- Positive: palpable shift or clunk between 20 and 40 degrees of flexion due to reduction of tibia on femur
Posterior sag sign
- Knee flexed 90 degrees
- Hip flexed 45 degrees
Slocum test
- Knee flexed 90, hip flexed 45
- Rotate pt’s foot 30 degrees IR
- Grasp proximal tibia with two hands, thumbs on tibial plateau, administer anterior directed force to tibia
- Positive: movement of tibia is primarily on the lateral side
- Indicates anterolateral instability
Can test anteromedial instability by ER foot 15 degrees
Valgus/ varus stress test
Knee flexed 20-30 degrees: MCL/ LCL
Knee straight: capsule + MCL/ LCL
Apley’s compression test
For mensicus lesion
- Prone, knee flexed 90
- IR/ER tibia while applying compressive force through tibia
- Positive: Pain or clicking
Bounce home test
For meniscus lesion
- Supine, Maximally flex knee
- Passively extend knee
- Positive: Incomplete extension or rubbery end feel.
McMurray Test
For posterior meniscus lesion
- Start with knee fully flexed
- Passively extend knee while medially rotating tibia
- Then extend knee while externally rotating tibia
- Positive: click or crepitation
Thessaly Test
For meniscus tear
- Stand on one leg with 5 degrees knee flexion
- Pt rotates femur on tibia laterally and medially 3 times.
- Repeat with 20 degrees knee flexion
- Positive: Joint line discomfort or catching/ locking
Brush test
For Knee Effusion
- Supine
- Place one hand below joint line, stroke proximally with palm and fingers as far as the suprapatellar pouch
- Then stroke down lateral knee
- Positive: Wave of fluid seen just below medial distal border of patella
Patellar tap test
For knee effusion
- Supine, knee in position of discomfort
- Apply slight tap over patella
- Positive: Patella appears to be floating
Clarke’s sign
For Patellofemoral Dysfunction
- Supine, knees extended
- Apply pressure distally over superior pole of patella
- Patient contracts quad
- Positive: failure to complete contraction without pain
Hughston’s Plica Test
- Supine
- Therapist flexes knee and IR tibia while other hand moves patella medially to palpate medial femoral condyle
- Positive: popping sound over medial plica while knee is passively flexed and extended
Noble compression test
For ITB Friction syndrome
- Supine, hip slightly flexed, knee flexed 90
- Thumb over lateral epicondyle of femur
- Maintain pressure while pt extends knee
- Positive: Pain over lateral epicondyle at approximately 30 degrees flexion
Patellar apprehension test
For patellar sublux/ dislocation
- Supine, knees extended
- Place both thumbs on medial border of patella, apply force laterally
- Positive: Apprehension or attempt to contract quads
