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Ortho tests > Knee > Flashcards

Knee Flashcards

1
Q

What does Clark’s test for

A

Chondromalacia patella, degen patfem Jt

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2
Q

Clark’s technique

A

Press patella inferiorly, pin in position
Ask Pt to contract quads slowly

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3
Q

+ve Clark’s

A

P on posterior surface of patella

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4
Q

-ve Clark’s

A

Pt can maintain contraction without pain
Control pressure carefully as false +ve can occur

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5
Q

Clarks clinical notes

A

Quad contraction compresses patella against femoral condyles

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6
Q

What does Ballotment’s test

A

Internal derangement, lig sprain/strain or rupture, vascular damage
Intra-articular knee swelling

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7
Q

Ballotments technique

A

Pillow under knee
Milk knee/quads
Movement top-bottom
Hold patella
Tap

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8
Q

+ve Ballotments

A

Rapid bounce, spongy feel, floating
Increased bulge over patella (fluid)

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9
Q

Ballotments clinical notes

A

Normally patella should move approx 1mm
With Jt swelling, ant to post motion will be increased as local edema raises the patella further of femur
Trauma is most common cause of effusion

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10
Q

What does Apley’s test

A

Comp- meniscal damage
Distract- capsule/ligament lesion/ CoLat lig sprain

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11
Q

Apley technique

A

Supine
Leg to 90
Place knee on hamstring
Distract- int/ext rot
Comp- int/ext rot

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12
Q

+ve Apley

A

Distract- relief

Comp- P, locking

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13
Q

Apley spec and sens

A

86-100
13-16

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14
Q

What does McMurray test for

A

Meniscal lesion
Tibial int rot- lat meniscus
Tibial ext rot- med meniscus

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15
Q

McMurray technique

A

Leg to 90
Dorsiflex foot, compress
Apply pressure into int/ext rot

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16
Q

+ve McMurray

A

P, locking, clicking, grinding

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17
Q

Potential cause of McMurray symptoms

A

Loose body of meniscus may cause snap/c

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18
Q

Signs of meniscal lesion

A

Knee Jt line P, crepitus with movement, locking of knee

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19
Q

McMurrays spec and sens

A

69-98
16-67

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20
Q

What does Age’s test

A

Meniscal lesion
Tibial int rot- lat meniscus
Tibial ext rot- med meniscus

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21
Q

Age’s technqiue

A

Test med meniscus – Lat rot each tibia maximally and squat, increasing distance between knees and lat rot
Lat meniscus – Both tibias med rot maximally, difficult even for a healthy Pt

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22
Q

+ve Ege’s

A

Pain or crepitus
Early flexion –anterior tears
Deep flexion – posterior horn tears

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23
Q

Eges spec and sens

A

81-90
64-67

24
Q

What does Thessalys test

A

Meniscal lesion

25
Thessaly technique
Use pracs hands for balance Stand on one leg, slightly flex Roate round- x3, bring Pt back to mid point
26
+ve Thessaly
P, buckling, catching, clicking Med/lat joint line discomfort
27
What does anterior drawer test
ACL sprain/rupture
28
Ant drawer technique
Same as acc movement, pull tibia anteriorly
29
+ve Ant drawer
P- ACL sprain Excessive movement- ACL rupture
30
Degrees of knee instability
1- mild, <5mm of translation 2- moderate, 5-10mm 3- severe, >10mm
31
Ant drawer spec and sens
86-100 18-95
32
What does post drawer test
PCR sprain/rupture
33
Post drawer test
Same as acc, push posteriorly
34
What does Lachman test for
Considered gold standard ACL, PCL
35
Lachman technqiue
Supine Flex leg to 15-30 deg Ant- stabilise femur, pull tibia ant Post- stabilise femur, push tibia
36
+ve Lachman
P- sprain Excessive movement- rupture Mushy/soft end feel, disappearance of infrapatellar slope
37
Potential cause of false -ve Lachman
False -ve may occur if femur is not properly stabilised or if meniscus lesion blocks translation or if tibia is medially rot
38
Bounce home test
Pt supine and relaxed Lift leg and bend knee to approx 20, by placing hand behind popliteal fossa Remove support allowing it to drop into full extension
39
Bounce home interpretation
Jt line P- meniscal tear Inability to full extend: 1. spongy end feel- swelling/edema 2. rubbery end feel/P- meniscal tear 3. hard- intra-articular fragment, osteochondritis dissecans
40
Bounce home clinical notes
Examiner should not fully remove hand from popliteal fossa, instead examiner should be there to support knee incase of P
41
Hughstons plica test
Pt supine leg straight Flex and medially rotates leg while applying medial to lateral force on patella with heel of hand Palpate medial condyle Apply force to patella while flexing and extending the knee and observing patella popping or shutter
42
Plica test interpretation
Popping or shuttering- plica inflam
43
Medial patella plica test
Pt supine Examiner passively flexes knee to 30 while applying lateral to medial force on patella with other hand Attempting to move patella medially
44
Medial patella plica test interpretation
Medial knee P- plica inflammation osteochondritis dissecans
45
Medial patella plica test clinic notes
By flexing knee and moving the patella medially an inflamed plica may cause tension between the patella and medial femoral condyle, which may cause P or discomfort
46
Noble compression test
Pt supine or sidelying Examiner applies lateral to medial pressure over the Pts lateral condyle with thumb and slowly flexes + extends leg (3-4 times)
47
Noble compression test interpretation
P over lateral femoral condyle or palpable tendon snapping- ITB syndrome
48
Noble compression clinical notes
Etiological factors of ITB - pelvic tilt, running or cycling - inc activity suddenly - leg length discrepency
49
Posterior sag sign
Pt supine with knee flexed to 90 Hips flexed to 45 Examiner compares prominence of tibial tuberosities bilaterally
50
Post sag sing interpretation
Tibia 'sags back' or 'drops back' on femur= PCL tear
51
Post sag spec and sens
100 83-100
52
Varus/valgus stress test
Valgus- medial force at knee Varus- lateral Slightly flexed
53
Varus/valgus interpretation
P- M/LCL sprain Inc motion/gapping- M/LCL rupture
54
Valgus clinical notes
Term valgus refers to distal bone moving laterally
55
MCL injury classification
Grade 1- 0-5mm of Jt p=opening, no instability 2- 5-10mm, mild instability 3- 10-15mm, moderate instability 4- >15mm, severe instability

Ortho tests (15 decks)

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