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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
Q

Thessaly technique

A

Use pracs hands for balance
Stand on one leg, slightly flex
Roate round- x3, bring Pt back to mid point

26
Q

+ve Thessaly

A

P, buckling, catching, clicking
Med/lat joint line discomfort

27
Q

What does anterior drawer test

A

ACL sprain/rupture

28
Q

Ant drawer technique

A

Same as acc movement, pull tibia anteriorly

29
Q

+ve Ant drawer

A

P- ACL sprain
Excessive movement- ACL rupture

30
Q

Degrees of knee instability

A

1- mild, <5mm of translation

2- moderate, 5-10mm

3- severe, >10mm

31
Q

Ant drawer spec and sens

A

86-100
18-95

32
Q

What does post drawer test

A

PCR sprain/rupture

33
Q

Post drawer test

A

Same as acc, push posteriorly

34
Q

What does Lachman test for

A

Considered gold standard
ACL, PCL

35
Q

Lachman technqiue

A

Supine
Flex leg to 15-30 deg
Ant- stabilise femur, pull tibia ant
Post- stabilise femur, push tibia

36
Q

+ve Lachman

A

P- sprain
Excessive movement- rupture

Mushy/soft end feel, disappearance of infrapatellar slope

37
Q

Potential cause of false -ve Lachman

A

False -ve may occur if femur is not properly stabilised or if meniscus lesion blocks translation or if tibia is medially rot

38
Q

Bounce home test

A

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
Q

Bounce home interpretation

A

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
Q

Bounce home clinical notes

A

Examiner should not fully remove hand from popliteal fossa, instead examiner should be there to support knee incase of P

41
Q

Hughstons plica test

A

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
Q

Plica test interpretation

A

Popping or shuttering- plica inflam

43
Q

Medial patella plica test

A

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
Q

Medial patella plica test interpretation

A

Medial knee P- plica inflammation osteochondritis dissecans

45
Q

Medial patella plica test clinic notes

A

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
Q

Noble compression test

A

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
Q

Noble compression test interpretation

A

P over lateral femoral condyle or palpable tendon snapping- ITB syndrome

48
Q

Noble compression clinical notes

A

Etiological factors of ITB
- pelvic tilt, running or cycling
- inc activity suddenly
- leg length discrepency

49
Q

Posterior sag sign

A

Pt supine with knee flexed to 90
Hips flexed to 45
Examiner compares prominence of tibial tuberosities bilaterally

50
Q

Post sag sing interpretation

A

Tibia ‘sags back’ or ‘drops back’ on femur= PCL tear

51
Q

Post sag spec and sens

A

100
83-100

52
Q

Varus/valgus stress test

A

Valgus- medial force at knee
Varus- lateral
Slightly flexed

53
Q

Varus/valgus interpretation

A

P- M/LCL sprain
Inc motion/gapping- M/LCL rupture

54
Q

Valgus clinical notes

A

Term valgus refers to distal bone moving laterally

55
Q

MCL injury classification

A

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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