Joint Specific Examinations Lower Extremity Flashcards
1
Q
Describe the Trendelenberg Test
A
- with patient standing, make sure their pelvis is level
- ask patient to stand on one leg
- positive: pelvis will fall on the unsupported side
- tests for gluteus medius strength
2
Q
Describe the Log Rolling Test
A
- while patient is supine, roll their leg in internal and external rotation
- tests for ROM
- internal rotation is first to be lost with hip arthritis
3
Q
Describe the Stinchfield’s test
A
- Have patient do an active straight leg test while supine
- positive: pain in hip
- tests for hip pathology like DJD, infection, or fx
- (localizes to hip, as opposed to low back pain)
4
Q
Describe the Thomas Test
A
-while patient lies supine, have them flex both hips and knees to their chest
release one leg at a time, allowing leg to extend to the table
-this flattens the lumbar back, taking it out of the equation
-positive: “contracture” of the released leg
-tests for contractures that prevent the leg from fully extending
5
Q
FABER test (Patrick’s test)
A
- flex, abduct, and externally rotate patient’s hip while they lie supine
- positive: pain
- checks for SI joint pathology as source of lumbar pain
6
Q
FADIR test
A
- place limb into flexion, adduction, and internal rotation
- positive: anterolateral hip pain
- checks for femoroacetabular impingement (hip impingement)
7
Q
Piriformis Test
A
- have patient lie in decubitus position with examined side up
- flex hip to 45’ and knee to 90’ (so that it “hangs” over the other limb)
- stabilize patient’s pelvis (preventing pelvic rotation) and press the flexed knee toward exam table
- positive: localized pain suggests piriformis tightness or tendonitis
- positive: diffuse, radiating pain indicates piriformes syndrome
8
Q
Ober Test
A
- patient lies in decubitus position with examined side up
- patient’s knee flexed to 90’, hip abducted to 40’, and hip is extended to its limit
- stabilize pelvis
- positive: limited ROM indicates contracture of the iliotibial tract
9
Q
Patellar Apprehension test
A
- have patient lie supine and abduct their limb so that the knee is flexed over the side of the table
- push the patella as far laterally as possible while slowly flexing the knee with the other hand
- positive: apprehension indicates imminent pateller disolcation
10
Q
Passive Patellar Grind Test
A
- press the patella against the femur while passively flexing the knee with the other hand
- Positive: pain; degree of flexion in which pain and crepitus is felt may clue to the area of articular cartilage damage
11
Q
Bounce Home Test
A
- patient lies supine and extends the knee as far as they can
- hold the heel and proximal tibia and gently and slowing extend the knee a bit farther
- positive: sharp pain at medial femoral condyle and medal ibial plateau
- tests for bucket handle tears of meniscus and ACL tear
- if torn ACL stump prevents extension, pain is described as central and deep
12
Q
Lachman’s test
A
- patient is supine with knees 20-30’ flexed
- place thumb over tibial tubercles and wrap other fingers around the calf
- the other hand’s thumb presses against the femur through the quadriceps tendon while other fingers wrap around thigh
- pull forward on the tibia and push backward on the femur
- assess amount of anterior translation
- positive: anterior translation >2mm; indicates ACL damage
13
Q
Quad Active Drawer Test
A
- patient is supine with knees 90’ flexed
- grasp tibia just below joint line and ask patient to flex their quads
- positive: the posteriorly subluxed tibia is seen shifting anteriorly into reduction
14
Q
How do you test for knee LCL strength?
A
-Apply varus stress to an “unlocked” knee (flex knee to 10-20’ to relax)
15
Q
How do you test for knee MCL strength?
A
-apply valgus stress to an “unlocked” knee (flex the knee 10-20’ to unlock)
16
Q
Pivot Shift Test
A
- have patient lie supine
- apply axial load, valgus stress, and external rotation on knee
- positive: knee “jumps” into a reduced position; indicates nonfunctional or ruptured ACL
17
Q
McMurray’s test
A
- patient lies supine and flexes knee as far as possible
- grasp patient’s hindfoot, externally rotate the foot, place a varus stress on the knee, and passively extend the knee while palpating the medial joint line (tests for medial meniscus tear or dysfunction)
- grasp hindfoot, internally rotate the foot, apply valgus force on the knee, and passively extend the knee while palpating the lateral joint line (tests for lateral meniscus tear or dysfunction)
