Knee Special Tests Flashcards
Patellar Ballotment test
looking for effusion
1. max effusion
pt supine
PT places hands 10cm above patella and 5 cm below
bring hands together and distal hand taps on the patella
positive if sound is heard. this is from the patella hitting the femur
2. mod effusion
pt supine
one hand on joint line, other 10 cm above.
bring hand closer to the joint and feel for fluid displacement at the joint line
3. min effusion
swipe cranially with compression on medial side of the knee 2-3 times and then palpate and do the same to the lateral side. look for fluid displacement to medial side
Zohler’s Test
testing for chondramalacia
PT pushes patella inferiorly and asks pt to contract quad.
if contraction is painful, may be indicative of chondramalacia or PFP
Clarke’s sign
patellar grind
same as zohlers test but compression is also given
positive test is pain upon contraction
PFP/chondramalacia may be present
Waldron Test
pt standind and performs unilateral squat to 90 deg while PT gives A-P force on patella
looking for any crepitus, locking of knee means PFP or chondramalacia
can also assess tracking and give information about alignment and Q angle
McConnell’s Patellar Alignment Test
pt seated on table with legs hanging off edge.
Resistance is applied to leg at varying deg of knee flex
120, 90, 60, 30, 0
pain at 60 is most indicative of Chondramalacia and PFP
if there is pain present at any angle but medial glide of patella makes the pain go away, it may be indicative of lateral tracking issue
Valgus Stress test
pt seated with legs hanging off edge of table
1. full knee ext
assess MCL, ACL, PCL, post med capsule, post ob ligament
2. 20-20 deg of flex
MCL, PCL, mid third of capsule, post ob ligament
3. 90 deg flex and full ER
posterior MCL
Varus Stress test
Pt seated with legs hanging off edge of table
- full extension
- LCL, ACL, PCL, arc pop complex, lateral capsular ligament - 10-30 deg of flex with full ER
- LCL, Arc pop comples, post lat capsule
Lachman Test
pt supine
PT beings knee into 30 deg of flex and gives ant force to tibia
MODIFIED: pt knee at 10-15 deg of flex
-closer to mechanism of injury, take out influence of hamstrings, less condylar influence (condyles nd meniscus do not block movement of tibia)
Godfrey Sign
Gravity sign pt supine PT beings legs itno 90/90 position and look for any dropping of tibial tuberosities -may indicated PCL involvement may also go active HS contraction
Posterior drawer sign
Pt supine with knee bend and hip bent
PT sits on foot and pushes tibia posteriorly
-excessive motion may indicate damage to PCL
Slocum Test
for ANTERIOR INSTABILITY P-A force
anteromedial
-hip flex 45, knee flex 90, and tibial ER 15
do P-A force on medial aspect of knee
-assess ACL, MCL, antpost med capsule, post ob ligament
Anterolateral
-hip flex 45, knee flexed 90, tibial IR 30
do P-A force on lateral aspect of knee
-assess ACL, PCL, LCL, ant post lat capsule, arc pop complex
Pivot-shift test
pt supine
leg ext with valgus force on distal femur and tibial IR
then flex knee, will hear clunk at 20-40 deg if ther eis tibial dislocation
Hughston’s Drawer test
POSTERIOR ROTATY INSTABILITY A-P force
Posterolateral
-hips flex 45, knee flexed 90, tibial ER 20
do A-P force on lateral aspect of knee
assess PCL, LCL, ant post lat capsule, arc pop complex
Posteromedial (RARE)
hip flex 45, knee flex 90, tibial IR
do AP force on medial aspect of knee
assess PCL, ACL, MCL, ant post med capsule, post ob lig
Dial test
pt supine with feet just off table
assess ER of tibia as 30 and 90 deg of flex
compare to both sides
If ER > 10 at 30 but NOT as 90, then positive posteriorlateral corner injury
If ER > 10 at 30 and 90, then positive PLRI and PCL
McMurrays test
pt supine with knee fully flexed
IR of tibia stresses Lateral meniscus
ER of tibia stresses Medial meniscus
