Knee - Special Tests

Question 1

Valgus Test

Answer 1

Patient suprine with knee slightly flexed (30 deg). Distal portion of leg abducted, knee pushed medially

+Test = increased laxity, pain

Indicates = Medial Collateral Ligament of Knee problem

KEY: If positive at 0 degree abduction, indicates joint capsule issue

Question 2

Varus Test

Answer 2

Patient supine, knee flexed slightly (30 degrees). Knee pushed laterally, distal leg pushed medially (adduction)

+Test = Pain, joint laxity

Indicated = Lateral Collateral Ligament of Knee problem

Key = if pain at 0 degree adduction, indicates joint capsule problem

Question 3

Anterior Drawer Test

Answer 3

Patient supine, knee flexed at 90. Doctor sits on foot, pulls tibia anteriorly

+Test = excessive translation (movement)

Indicates: ACL tear/rupture

Question 4

Posterior Drawer Test

Answer 4

Patient supine, knee flexed at 90. Doctor sits on foot, moves tibia posteriorly.

+Test = excessive translation (movement)

Indicates = PCL tear/rupture

Question 5

Lachman’s Test

Answer 5

Patient supine and knee flexed 10-30 degrees. Hand placed on thigh, the other placed on back of leg. Thigh hand pushes down while leg hand pulls tibia anteriorly.

+Test = increased laxity

Indicates = ACL tear/rupture

Question 6

McMurray’s Test (Lateral and Medial)

Answer 6

Patient supine, thigh and knee flexed. Hand on dital femur, hand on ankle

Lateral Meniscus – Varus force, ankle internally rotated. Bring leg into extension and lower to table listening for popping

Medial Meniscus – Valgus force, ankle externally rotated. Bring leg into extension and lower to table.

+Test = pop or click heard

Indicates = Possible tear of medial/lateral meniscus

Question 7

Apley’s Grind Test – Compression

Answer 7

Patient prone. Knee flexed to 90. Examiner applies force into knee while roating FOOT internally and externally

+Test = pain with rotation and/or compression

Indicates = possible meniscal injury, collateral ligament injury or both

Question 8

Apley’s Grind Test - Distraction

Answer 8

Patient prone with leg flexed to 90. Examiner applies upward traction (pulls) to leg and rotates

1) +Test = Pain with distraction/rotation

Indicates = Possible collateral ligament issue

2) +Test = relief of pain

Indicates = possible meniscus injury

Question 9

Patella-Femoral Grinding Test

Answer 9

Compress patella caudally into trochlear groove. Have patient tighten quads against resistance

+Test = crepitus or pain

Indicates = roughness of articulatimng surfaces (i.e. chondromalacia)