LE Special tests Flashcards
Test for nerve root compression (L4-S1) due to a lumbar intervertebral disk herniation; positive is symptoms 30-70 degrees, then should be followed by test for sign of the buttock
SLR
- normal female = 80*
- normal male = 70*
What does the sign of the buttock indicate?
possible bursitis, abscess, or neoplasm
-pain occurs on posterior side with knee flexed 90 and hip flexed
Test for tight hip flexors; implicates hip capsule tightness, osteoarthritis, or adductor tightness; pain on anteromedial thigh is indicative of hip joint implication
FABER test
- posterior pain = SI joint, bursa, sciatic nerve or posterior capsule
- positive test if leg doesn’t come down to life of other leg
Test performed with pt sitting edge of plinth and assumes a fig 4 position; positive test if pt can’t perform test and pain is present; may indicate OA, or decreased flexibility in hamstrings, glut max, or mutlifus
Jansen’s test
Pt sits on edge of plinth and examiner extends one leg at a time; positive test for tight hamstrings if pt extends trunk/ reaches back with hands
Tripod test
long sitting with one leg bent and one leg straight, reach to toes of straight leg with both hands; knee coming up = tight hamstrings; abd of flexed LE = tight TFL/ITB; add of flexed LE = tight add
Hamstring contracture test
long sitting have the pt lean forward to touch their toes; screening for low back/ erector spinae, gluts, hamstrings, gastroc/ soles couplex
Wells Bend and Reach test
Pt supine (level ASIS), adducted leg is pulled into neutral; positive test if same side ASIS rises
adductor contracture
- same test for abductor contracture but involved side will be abducted and pelvis will shift downward when pulled into neutral
What indicates a positive FADIR test?
pain with pressure
- can do a passive stretch for posterior/ lateral structures
- compression = anterior medial structures
pt supine, flex knee with minimal abd, take patient into IR then ER, (stop when greater trochanter is most prominent); ante version = increased IR, retroversion = increased ER
Craig’s test
- female IR = 45
- male IR = 35
- male and female ER = 45
Pt supine with thighs ½ way off and contralateral leg flexed; do test in both adduction and abduction
Thomas test
- test for tight hip flexors
PT prone with passive knee bend while stabilizing the PSIS; monitor for increased lumbar lordosis
Ely test
Sidling; abd and estend upper leg and passively lower the leg, leg should touch exam table
Ober test
- knee flexed should result in lowering of leg, however if TFL is tight it will raise due to retinacular fibers over knee
pt standing; marks are made 5cm below and 10cm above PSIS; pt goes into flexion, should have 20+ cm, if not it indicates tight erector spinae
modified schooner test
What tests are done for effusion at the knee?
- milking test
- girth measurement
- Ballotment test (push down on knee cap)
What tests are done for PF mobility?
- med/lat/cep/caud glides
- med/lat tilts
- pf active/ passive tracking
- looking for grinding
What tests are done for meniscus injury?
- McMurray’s test (dynamic component as well)
- Apley’s compression (with DDV)
- Recurvatum
What tests are done for PCL injuries?
- recurvatum
- Sag test (with clanky’s step up)
- posterior drawer
What tests are done for ACL injury?
- anterior drawer
2. lachman’s test
What tests are done for collateral ligaments?
- Varus stress (0* and 30*)
- Valgus stress (0* and 30*)
- Apley’s distraction (with DDV)
How should the patella track?
Should have a “J” pattern 30-60 degrees in OC
patient in long sitting, passive DF, 1st MTP in extension; palpate from calcaneal tubercle along the bands of MT 1,2,3 to elicit pain, indicating positive test
Plantar fascia test
tap test over posterior tib nerve; used for tarsal tunnel syndrome [flexor retinaculum pressure may compress post tib leading to reproduction of neurological S and S]
Tinel sign
What is the minimum ROM for the 1st MTP joint for normal toe off for gait? [compensate is stoppage gait or excessive pronation; abnormal extension can lead to patella-femoral pain (orthotic recommendation)]
50-70 degrees
-in class, 78 degrees
Assessing for PF 1st ray: lateral 4 Mts stabilized and 1st ray is moved into PF and DF. What should the normal ratio be?
1:1
What indicates morton’s foot? what can this lead to?
2nd ray is longer than 1st ray
- can cause hypo mobility in 2nd ray due to synovitis or capsulitis
When assessing STJ alignment, what should the ratio of inversion be compared to eversion?
⅔ of movement should be inversion, ⅓ should be eversion
If FF valgus is suspected what should you heck for?
a PF 1st ray
Test for ankle that tests the ATF and uses 6.6 pounds of force; knee needs to be flexed
Anterior drawer test of the ankle
What does the posterior drawer test of the ankle test?
PTF lig
What does the varus stress test of the ankle test?
CF lig
What test should you always include with a lateral ankle sprain?
tests for cuboid syndrome
- tender upon palpation
- 10x PF in WB
- FF adduction
- supinate and pronate foot passively
Tests involvement of deltoid lig; eversion/ valgus rotation of the calcaneus only
Valgus stress tess
General test for deltoid complex; evert/ valgus rotation where calcaneus is rotated with FF and mid foot passively rotated as well
Rotation test
Test for deltoid lig; hand is placed over dorsal of foot, mid foot and FF laterally rotated (duck foot)
Kleiger test
Test for high ankle sprain; mechanical compression to calcaneus
Tap test
Test for high ankle sprain; compress tib and fib space to elicit symptoms
compression/distraction test
What is the typical mechanism of injury for a high ankle sprain?
DF and ER at foot
- causes separation of interosseous membrane; tests performed in this stance are most indicative of high ankle sprain
