LE Special Tests

Question 1

Scour Test

Answer 1

technique: Patient in supine with the hip flexed and adducted. Hip is taken into abduction while maintaining hip flexion. Compressive load is added whilst completing this.

positive test is reproduction of familiar pain or apprehension.

What is it used to diagnose: general hip pathology and DJD

Question 2

patrick FABER Test

Answer 2

technique: hip is flexed with combined abduction and external rotation. foot should be resting on the contralateral leg when in the finished position.

positive if the knee is unable to relax in this position or if pain is reproduced.

What is it used to diagnose: identifies a mobility restriction at the hip

Question 3

FADDIR

Answer 3

technique: flexion adduction and internal rotation

Positive test if there is reproduction of symptoms with our without a click or noise.

What is it used to diagnose: anterior superior impingement, illiopsoas tendinopathy, and anterior labral tears.

Question 4

Thomas test

Answer 4

technique: in supine - one knee and hip maximally flexed to the chest and the other leg is straight on the table.

positive test if the hip on the table is risen off of the table

What is it used to diagnose: tightness in hip flexors

Question 5

OBER test

Answer 5

technique: patient is in sidelying with the lower limb flexed at the hip and knee. Take the top leg and passively extend with the knee at 90 degrees of flexion and lower the limb toward the table

positive test if the leg remains above the horizontal.

What is it used to diagnose: tight ITB/TFL

Question 6

Ely test

Answer 6

technique:patient in prone - flex the knee passively.
positive test if hip of tested limb flexes.
What is it used to diagnose: tight rectus femoris

Question 7

90/90 hamstring test

Answer 7

technique: Supine hip and knee supported in 90 degrees of flexion. passively extend the knee until tightness is encountered. positive test if the knee lacks 10 degrees or greater of knee extension
What is it used to diagnose: tightness of hamstring.

Question 8

piriformis test***

Answer 8

technique: patient in supine - foot of tested limb is passively placed lateral to opposite limbs knee with the tested hip adducted
What is it used to diagnose: piriformis tightness and syndrome.

Question 9

trendelenburg sign

Answer 9

technique:patient in standing and asked to stand on one leg - shown inability or unsteadiness.
What is it used to diagnose: weakness of glut med and unstable hip

Question 10

leg length

Answer 10

technique: measurement of ASIS to lateral malleolus - patient in supine
What is it used to diagnose: true leg length discrepancy

functional vs true leg length discrepancy

true - caused by an anatomical difference in bone lengths
functional - not anatomical - result of compensation due to abnormal positioning or posture such as ankle pronation or inominate rotation.

Question 11

leg length

Answer 11

technique: measurement of ASIS to lateral malleolus - patient in supine
What is it used to diagnose: true leg length discrepancy

functional vs true leg length discrepancy

true - caused by an anatomical difference in bone lengths
functional - not anatomical - result of compensation due to abnormal positioning or posture such as ankle pronation or inominate rotation.

Question 12

patellar pubic percussion test

Answer 12

technique: with the patient in supine the examiner percusses teach patella seperately while auscultating the pubic symphysis with a stethoscope -

positive test if decreased percussion note on the affected side.

What is it used to diagnose: hip fracture

Question 13

lachman test

Answer 13

technique:patient is in supine with the knee flexed 20 to 30 degrees. pressure on the femur while pulling up on the tibia.
positive if there is excessive movement compared to the contralateral side.

What is it used to diagnose: 1 plan anterior instability (ACL)

Question 14

anterior drawer test

Answer 14

technique: Patient is in supine with the hip flexed to 45 and knee to 90. PT pulls from the posterior proximal tibia anteriorly. Positive is marked laxity compared to the contralateral side.
What is it used to diagnose: ACL tear and 1 plane anterior instability.

Question 15

posterior drawer

Answer 15

technique: Patient is in the same position as the anterior drawer - 45 degrees flexion of the hip and 90 degrees flexion of the knee. posterior pressure put to stress the PCL

What is it used to diagnose: PCL and posterior single plan instability.

Question 16

posterior sag sign

Answer 16

technique: same position as posterior drawer but you just see if the tibia sags posterior
What is it used to diagnose:

Question 17

valgus stress test

Answer 17

technique: Patient is in supine with the knee resting on the edge of the exam table - a valgus stress is applied at 0 and 30 degrees of knee flexion -

positive test is pain or increased motion -

positive finding at 0 degrees of extension indicates major disruption of the knee with one or more rotatory tests also positive

What is it used to diagnose: medial instability/ MCL

Question 18

Varus stress test

Answer 18

technique:Patient is in supine with the knee resting on the edge of the exam table - a varus stress is applied at 0 and 30 degrees of knee flexion

positive test is pain or laxity in the joint

positive finding at 0 degrees of extension indicates a major disruption of the knee with one or more rotatory tests also positive.
What is it used to diagnose: lateral instability/ LCL

Question 19

pivot shift test

Answer 19

technique: patient is in supine with the knee in extension, hip flexed/abducted to 30 degrees with slight internal rotation

holding the knee with one hand, and foot with the other hand place a valgus force through the knee and flex the knee.
What is it used to diagnose: anterolateral instability +ACL

Question 20

McMurray Test

Answer 20

technique: Patient is in supine with the knee in maximal flexion.

This can be used to test the medial or the lateral meniscus

example - lateral meniscus - passively internally rotate and extend the knee.

positive test if there is a pop or click or pain in the joint
What is it used to diagnose: medial or lateral meniscus tear

Question 21

thessaly test

Answer 21

technique: patient standing on the symptomatic leg holding the examiners hands (like dancing)

patient rotates the body and leg internally and externally with the knee flexed to 5 degrees and then 20 degrees

positive test if there is popping/clicking and pain.
What is it used to diagnose: meniscus tear

Question 22

Patellar apprehension test

Answer 22

technique: Patient in supine with the knee flexed to 30 degrees and quadriceps relaxed - passively move the patella laterally - positive test if the patient expresses apprehension or contracts the quadriceps to prevent patella from dislocation.

What is it used to diagnose: patellofemoral instability.

Question 23

patellar tilt test

Answer 23

technique: patient is in supine with the knee extended - lift the lateral edge of the patella from the lateral femoral condyle - positive test if the patient expresses apprehension or contracts the quadriceps to prevent patella from dislocation

What is it used to diagnose: patellofemoral instability.

Question 24

Nobel compression test

Answer 24

technique: Patient in supine with the knee flexed to 90 degrees with hip flexion.

pressure is aplied 1 to 2 cm proximal to laterl fremoral epicondyle - with pressure maintained - patients knee is passively extended

positive if the patient is experiencing pain in the lateral femoral condyle.

What is it used to diagnose: IT band friction syndrome

Question 25

brush (stroke) test

Answer 25

technique: patient is in supine with the knee in full extension

starting at the meidal tibifemoral joint, stroke upward two or three times toward the supralateral pouch then stroke downward on the distal lateral thigh just superior to the suprrapatelar pouch toward the lateral joint line.

What is it used to diagnose: swelling

Question 26

Ottawa knee rules***

Answer 26

patient is 55 or above
patient inability to bear weight
pain to palpation exclusively on the patella without other bone tenderness
tenderness on the fibular head inability to flex the knee to 90 degrees

Question 27

ottawa ankle rules ***

Answer 27

Tenderness to the distal 6 cm of the tibia (medial malleolus)
Tenderness to the distal 6 cm of the fibula (lateral malleolus)
inability to bear weight in the ER for 4 steps at the initial evaluation or at the time of injury

Question 28

Ottawa foot rules ***

Answer 28

tenderness to the navicular
tenderness to the base of the 5th
inability to bear weight for at least 4 steps at the time of the evaluation and immediately after evaluation

Question 29

anterior drawer test

Answer 29

technique:translate talus anteriorly while stabilizing the leg.
positive if there is pain and or excessive motion compared to the other side.
What is it used to diagnose: ATFL rupture or ligamentous instability

Question 30

talar tilt

Answer 30

technique: patient is in sideliying - knee slightly flexed - ankle in neutral - move the foot into maximal adduction (calcaneofibular) and abduction (deltoid ligament)
What is it used to diagnose: Calcaneofibular ligamentous instability.

Question 31

medial subtalar glide test

Question 32

external rotation stress (kleiger test)

Answer 32

technique: patient is seated with the knee flexed to 90 degrees and the ankle in neutral

apply external rotation force to foot while holding the tibia in a neutral position.

positive test if there is pain or a visible gapping

What is it used to diagnose: integrity of the distal tibiofibular syndesmosis

Question 33

dorsiflexion external rotation test

Answer 33

technique: maximally dorsiflex - externally rotate the foot while keeping the tibia in a neutral position
What is it used to diagnose: integrity of the distal tibiofibular syndesmosis

Question 34

squeeze test

Answer 34

technique: patient seated with the knee flexed to 90 degrees - apply compression between the middle and distal third of the patients legs.
What is it used to diagnose: distal tibiofibular syndesmosis integrity

Question 35

THOMPSON TEST

Answer 35

ACHILLES SQUEEZE -

if positive - this indicated an IMMEDIATE referral to the orthopedic position - delayed diagnosis results in poor prognosis.

Question 36

windlass test

Answer 36

technique: lift the big toe
What is it used to diagnose: plantar fasciitis

Question 37

weight bearing test

Answer 37

technique: patient standing on the step with toes positioned over the edge of the step and equal weight bearing - passively extend the big toes MTP joint

What is it used to diagnose: plantar fasciitis

Question 38

non weightbearing test

Answer 38

technique: the patient seated in non weighrt bearing position with the knee flexed to 90 degrees - stabilize the ankle and passively extend the patients first MTP joint - same as weight bearing but just not in a WB position.
What is it used to diagnose: plantar fasciitis