knee - special tests

Question 1

q-angle (quadriceps) test

Answer 1

▪ Positions patient supine, with the hips and knees extended
▪ Positions the goniometer at the knee so that the axis is over the midpoint of the patella, the stationary arm is in line with
the ASIS, and the moving arm is in line with the tibial tubercle
▪ Reads the goniometer to determine the Q-Angle
▪ A positive test is indicated by an angle that is lesser or greater than 13 degrees for males and 18 degrees in females
▪ Tests for patellofemoral pathology

Question 2

ballotable patella (patella tap) test

Answer 2

▪ Positions patient supine, with knee extended, and quadriceps muscles relaxed
▪ Places one hand over the superior portion of the knee and the other hand over the inferior portion of the knee to push any
fluid toward the patella
▪ Uses a finger to depress the patella down towards the femur
▪ A positive test is indicated by a “bouncing back” of the patella after being depressed
▪ Tests for joint effusion within the knee capsule

Question 3

sweep (brush, stroke, or milking) test

Answer 3

▪ Positions patient supine, with the knee extended
▪ Uses one hand to stroke edema in a proximal manner to the opposite side of the knee
▪ Applies pressure on the side of the knee to which the fluid was moved to see if it moves to the opposite side of the knee
▪ A positive test is indicated by the reformation of edema on the original side of the knee when pressure is applied to the
opposite side of the knee
▪ Tests for joint effusion within the knee capsule

Question 4

patella apprehension (fairbank’s) test

Answer 4

▪ Positions patient supine, with the knee extended
▪ Places both thumbs along the medial aspect of the patella
▪ Gently glides the patella in a lateral direction
▪ A positive test is indicated by apprehension and/or guarding of the quadriceps muscle group
▪ Tests for patella subluxation or dislocation

Question 5

hughston’s plica (medial plica) test

Answer 5

▪ Positions patient supine, with the knee extended
▪ Places the heel of one hand over the lateral patella border, and the palm over the medial femoral condyle
▪ Places other hand around the athlete’s ankle/foot
▪ Passively flexes and extends the knee, while internally rotating the tibia and simultaneously pushing the patella in a medial
direction
▪ A positive test is indicated by pain and/or popping
▪ Tests for knee plica pathology

Question 6

noble compression test

Answer 6

Positions patient supine with the knee flexed
▪ Holds the ankle with one hand
▪ Places the thumb of the other hand over the lateral femoral condyle
▪ Passively extends and flexes the knee while applying pressure over the lateral femoral condyle with the thumb
▪ A positive test is indicated by pain over the lateral femoral epicondyle at approximately 30 degrees of knee flexion
▪ Tests for iliotibial band friction syndrome

Question 7

mcmurry’s test

Answer 7

▪ Positions patient supine, with the knee flexed
▪ Places one hand around the heel of the foot
▪ Places the fingers of the other hand over the medial and lateral joint lines of the knee
▪ With the knee fully flexed, externally rotates the tibia, applies a valgus force, and extends the knee
▪ With the knee fully flexed, internally rotates the tibia, applies a varus force, and extends the knee
▪ Repeats with the tibia internally rotated and a varus force applied to the knee
▪ A positive test is indicated by joint line pain and/or clicking/popping sensation
▪ Tests for a lateral and/or medial meniscal tear

Question 8

apley’s compression test

Answer 8

▪ Positions patient prone, with knee flexed 90 degrees
▪ Stabilizes the distal thigh with one hand
▪ Hold the heel with the other hand
▪ Applies a downward force with the tibia
▪ Internally and externally rotates the tibia
▪ A positive test is indicated by joint line pain and/or clicking/popping sensation
▪ Tests for a lateral and/or medial meniscal tear

Question 9

thessaly test

Answer 9

▪ Positions patient standing on one leg, with the contralateral knee flexed to 45 degrees
▪ Hold the patient’s arm for support
▪ Instructs patient to flex the knee to 5 degrees, then internally and externally rotate the femur on the tibia three times
▪ Instructs patient to flex the knee to 20 degrees, then internally and externally rotate the femur on the tibia three times
▪ A positive test is indicated by joint line pain and/or clicking/popping sensation
▪ Tests for a lateral and/or medial meniscal tear