hip/knee practical Flashcards
Patellar apprehension test positive sign and implication
lateral glide on patella
Positive sign: contraction of the quads
Implication: laxity of medial patellar apprehension
Valgus stress test positive sign and implication
0 and 25 degrees apply lateral force
Positive sign: pain/laxity or both
Implication: sprain of MCL
Varus stress test positive sign and implication
0 and 25 degrees apply force on medial knee
Positive sign: pain/ laxity or both
Implication: sprain to LCL
Prox tib-fib joint play positive sign and implication
Ant and post force to fibular head
Positive sign hypermobility - damage to ant or post tib-fib lig or syndesmosis
hypomobility - adhesions/restrictions
Patellar glides positive sign and implication
knee flexed 30 degrees medial and lat glide
medial should move 1-2 quadrents
lateral should move .5-2 quadrents
Positive sign: hypermobility - sprain to medial or lateral retinaculum
Hypomobility - adhesion or tightness in med or lat patellar restraints
Sweep test - how to do it, positive sign, implication
how: medial knee superior sweep, lateral knee inferior sweep
positive: ball of swelling appears in medial joint line
Implication: intracapsular swelling
Ballotable patella - how, positive sign, implication
how: squeeze superior and inferior swelling then use thumb to depress patella
positve: slow rise of patella
implication: intracapsular swelling
Anterior drawer - how, positive sign, implication
how: knee at 90 pull tibia to neutral then lean back
positive: laxity
implication: sprain of anteromedial bundle of acl
Lachmans test - how, positive sign, implication
how: stabilize femur and pull tibia
positive sign: laxity
implication: sprain of posterolateral bundle of acl
reverse lachmans - how, positive sign, implication
how: prone with knee off table downward pressure
positive sign: laxity
implication: sprain of posterolateral bundle of acl
posterior drawer - how, positive sign, implication
how: knee at 90 pull tibia to neutral then push knee back
Positive sign: laxity
implication: sprain of PCL
Godfrey’s sign - how, positive sign, implication
how: grab ankles hip and knee flexed 90
positive sign: sag of tibial tuberosity
implication: pcl sprain
quadriceps active test - how, positive sign, implication
how: knee 90 degrees hold foot/ankle tell them to push against your hand
positive sign: ant translation of tibia on femur
implication: grade 2 or 3 PCL sprain
pivot shift - how, positive sign, implication
how: hope i dont do it
positive sign: tibial subluxation
implication: anterolateral rotarory instability
slocum drawer test - how, positive sign, implication
how: tibia interally rotated and ant drawer (ALRI), tibia externally rotated and ant drawer (AMRI)
positive sign: laxity
crossover test - how, positive sign, implication
how: stand on involved limb and bring leg across and behind
positive sign: pain, instability, apprehension
Implication: ALRI across in front, AMRI across and behind
Slocum ALRI - how, positive sign, implication
how: side lying valgus force while forcing knee into flex
Postive: clunk or pain
implication: alri
dial - how, positive sign, implication
how: prone with knees together grab feet and ext rotate 30 degrees and 90 degrees
postive sign: difference of 10 degrees EROT
implication: 30 only - injury to posterolateral corner
90 degrees only - PCL sprain
both - PLRI
external rotation recurvatum - how, positive sign, implication
how: grab toes and lift 12 inches
positive sign: difference in hyperextension, ext rot and varus alignment
Implication: PLRI, PCL injury, posterolateral corner injury
Hughstons- how, postive sign, implication
how: tibia externally rotated and post drawer (PLRI), tibia internally rotated and post drawer (PMRI)
positive sign: laxity
dynamic post shift test - how, positive sign, implication
how: hold jt line passively flex knee and hip 90 degrees and passively extend
positive: clunk or jerk as knee nears extension
implication: PLRI
McMurrays - how, positive sign, implication
how: figure 8 of knee
positive: popping, clicking, locking with or without pain
implication: meniscal tear
Apleys compression/distraction - how, positive sign, implication
how: prone knee flex 90 push down and rotate tibia
- if pain distract and rotate tibia
positive sign: pain in compression relieved with distraction
implication: meniscal tear
Thessalys test - how, positive sign, implication
how: stand on affected leg with slight bend (5 degrees and 20 degrees), hold hands and rotate
postive sign: joint line discomfort, locking/catching
Implication: meniscal tear
Nobles test- how, positive sign, implicatoin
how: hold joint line and passively flex/ext knee
positive sign: pain under thumb near 30 degrees flex
Implication: inflammation of ITB, bursa, or lat fem condyle
Obers test - how. positive sign, implication
how: side lying on nonaffected side, circumduct hip and observe
Positive sign: femur only reaches horizontal or cant reach horizontal
Implication: ITB tightness
Wilsons test- how, positive sign, implication
how: short seated pt internally rotates tibia and extends if pain externally rotate
positive: pain on internal that is relived with external
implication: osteochondral defect in medial fem condyle
Stutter test- how, positive sign, implication
how: hold patellar borders and have pt slowly extend knee
positve sign: motion or stuttering between 40-60 degrees flex
implication: symptomatic medial synovial plica
test for medial synovial plica - how, positive sign, implicatoin
how: medially glide patella while flexing hip to 90 degrees with tibia internally rotated
positive sign: reproduction of symptoms and possible stutter between 40 and 60 degrees flex
implication: symptomatic synovial plica
