Knee Special Tests Flashcards
What are 8 special tests for ligamentous instability at the knee?
- Anterior Drawer Test
- Lachman test
- Lateral pivot shift test
- Posterior Drawer Test
- Posterior Sag Sign
- Slocum Test
- Valgus Stress Test
- Varus Stress Test
Where is the knee flexed to during a Lachman’s test?
20-30 degrees of flexion
What is the Lateral Pivot Shift Test?
- Pt is positioned supine with the hip flexed and abducted to 30 degrees with slight internal rotation. KNEE EXTENDED
- PT grasps the leg with one hand and places the other hand over the lateral surface of the proximal tibia
- PT medially rotates the tibia and applies a valgus force to the knee while the knee is slowly flexed.
Positive: palpable shift or clunk occuring between 20-40 degrees of flexion which is indicative of anterolateral rotatory instability
Basically start by subluxing tibia and then move from extension to flexion to reduce it
-the shift or clunk results from reduction of tibia on femur that could be from torn ACL
What is the position for the posterior sag sign? What does it indicate?
knee flexed to 90, hip to 45.
PCL injury
What is Slocum test?
Pt in supine with knee flexed to 90 and hip to 45.
- PT rotates the patient’s foot 30 degrees medially to test anterolateral instability.
- PT stabilizes the lower leg by sitting on forefoot.
- PT grasps the pts proximal tibia with tow hands, places thumbs on tibial plateau, and administers an anterior directed force to the tibia on the femur.
Positive: movement of tibia occurring primarily on the lateral side and may indicate anterolateral instability.
CAN ALSO test anteromedial instability by rotating the patient’s foot 15 degrees laterally
What does a positive for the Valgus stress test indicate in 20-30 degrees vs. full extension?
20-30: MCL sprain
Extended: damage to the MCL, PCL, posterior oblique ligament, and posteromedial capsule
What does a positive for the Varus stress test indicate in 20-30 degrees vs. full extension?
20-30: LCL sprain
Extended: damage to the LCL, PCL, arcuate complex and posterolateral capsule
What are 4 tests for Meniscal pathology?
- Apley’s Compression Test
- Bounce Home Test
- McMurray Test
- Thessaly Test
What are two tests for swelling?
- Brush Test
2. Patellar Tap test
What is Apley’s Test?
Pt in prone with knee to 90
-PT stabilizes femur and compresses through heel while medially and laterally rotating
What is Bounce home test?
Pt in supine
-PT grasps the patients heel and maximally flexes the knee, pt knee is extended passively
-BASICALLY FLEXING AND ALLOWING LEG TO DROP INTO EXTENSION (BOUNCE HOME)
Positive: incomplete extension or a rubbery end feel may be indicative of a meniscal lesion
What is a McMurray test?
Pt in supine.
- PT grasps the distal leg with one hand and palpates the knee joint with the other
- With the knee fully flexed, the PT medially rotates the tibia and extends the knee. Repeat while laterally rotating tibia.
What is Thessaly test?
Pt stands on one leg with 5 degrees of knee flexion
- Pt rotates femur on tibia laterally and medially 3 times
- repeat in 20 degree knee bend
-Perform on unaffected first
What is the Patellar tap test?
Pt positioned in supine with the knee flexed or extended to a point of discomfort. the PT applies a slight tap over the patella.
Positive: if the patella appears to be floating and may be indicative of joint effusion
What is the Brush test?
Pt in supine. PT strokes proximally on medial surface of patella
-PT then strokes down the lateral surface of patella
Positive: wave of fluid below the medial distal border of patella
