LE special tests Flashcards
What does the FABER test look for?
general hyp dysfxn, like mobility restriction
- positive if reproduce pain or knee not able to relax/lower
How do you perform the scour test?
looks for hip DJD
- pt supine with hip in 90, knee max flexion
- compressive load through femur to load hip joint
may have pain in hip, but could refer to knee or elsewhere
What is ely’s test?
looks at tightness of rectus femoris: prone with knee flexed so foot touches but
- positive if hip of testing limb flexes
What would be considered a positive 90-90 hamstring test?
if pt is unable to get to 10 degrees from neutral (lacking 10deg ext)
What is the test for piriformis syndrome?
- place test limb in knee flexion so that test leg’s foot is lateral to relaxed knee
- internally rotate limb
- positive is test knee is unable to pass over resting knee, or reproduction of pain in butt/sciatic n. distribution
What is Craig’s test?
looks for abnormal femoral anteversion
- pt prone, knee flexed to 90
- palpate greater troch while moving hip through IR/ER
- when you feel greater troch pop out most, keep leg there and measure angle of leg relative to a line perpendicular with the table surface
typical is 8-15deg
- less than 8 = retroverted hip
- more than 15 = anteverted hip
What is FADDIR/FADIR used for?
anterior-superior impingement, iliopsoas tendonopathy, and anterior labral tears
- positive = pain with or without click
At what degree of knee flexion should the knee be placed for valgus/varus stress testing?
20-30deg KF
How do you perform the lachman stress test?
pt supine w/ KF to 20-30deg, stabilize femur on your thigh
- attempt to bring tibia anterior
What does the pivot shift test for? How do you do it?
anterolateral rotary instability
- pt supine: hip flexed and abducted 30 deg, knee straight, slight IR
- provide valgus force at knee and bring knee into flexion
positive = tibia clunks backward at about 30-40KF, indicating ligament laxity
What does the “clunk” in a pivot shift test indicate?
tibia was subluxed before the test, however was then reduced by the pull of the IT band as the knee was flexed
What’s the posterior sag test?
testing for lax PCL
- in supine, hip flexed to 45, knee flexed to 90
- observe to see if tibia “sags” in this position
In one of the Lachman’s tests, the patient is prone, and you’ve bent the knee to 30deg KF. You attempt to bring the tibia posterior. What ligament is being tested?
PCL
- pushing down to bring tibia anterior would be testing ACL
How do you perform McMurray’s test?
pt supine, knee in max flexion
- passively IR and extend the knee repetitively (lateral meniscus)
- then bring knee back up into flexion and extend with ER repetitively (testing medial meniscus)
How would you differentiate ligamentous issue vs meniscal issue on a patient with knee pain?
do apley test
- prone, knee flexed to 90
- distract tibia, then rotate IR/ER
- compress axial load through tibia, then rotate IR/ER
pain with compressioin = meniscus
pain with distraction = ligamentous
How do you test for plica dysfunction in the knee?
Hughston’s plica test
- pt supine, knee flexed with tibia IR’ed
- passively glide patella medially while palpating medial femoral condyle
- looking for popping as you passively flex/extend knee
In what direction do you glide the patella in the patellar apprehension test?
laterally -> pt won’t let you if they’ve had subluxations before cause the patella always goes laterally in those
If you get a positive sign on the ballotable patella test, what does this mean?
positive if you tap the knee cap and it looks like it’s floating/”dancing”
- means infrapatellar effusion
What is Clarke’s sign?
indicates PF dysfunction
- pushing posterior on superior pole of patella while leg is extended
- pt then makes active quad contraction, and pain = positive test
What is the normal Q-angle for men and women? How do you measure for this?
men = 13deg women = 18deg
measure the angle between the quadriceps muscle and the patellar tendon
- angle greater/less than normal may indicate knee dysfxn
Where do you tap for Tinel’s sign to look for common fib n. dysfxn?
tap posterior to fibular head
What test idenfities osteochondritis dissecans of the medial femoral condyle?
pt sitting on edge of table, actively extends knee with IR of tibia
- positive if pain present at 30deg with IR but no pain at 30deg with ER
Where do you grab the forefoot in subtalar neutral?
pinky side: laterally
What does the anterior drawer test of the ankle look at? How to perform?
looks at laxity of ATF
- pt supine with heel just off table
- stabilize lower leg, bring talus anterior
What ligament does talar tilt look at?
calcaneofib
- abduction tilt tests deltoid ligament
What does Thompson’s test look at?
integrity of achilles tendon
Where would you tap with Tinel’s sign to identify dysfunction of posterior tibial nerve? What about deep fibular nerve?
posterior tib: tap medial malleolus
deep fib: anterior to talocrural joint, over dorsal retinaculum
What test identifies stress fracture/neuroma in forefoot? How to test this?
morton’s test
- grasp around met heads and squeeze
How do you perform Kleiger test?
idenfities integrity of distal tibfib syndesmosis
- pt seated at edge of table
- apply ER force to foot while holding tibia neutral
- positive if joint gapping reproduced
What is a positive Ely’s test?
hip rising in prone when attempting to flex knee to butt
Where do you compress in Noble compression test?
lateral femoral condyle
What is the Windlass test and how is it performed?
done in WB position; looks at windlass effect of plantar fascia
- pt stands on step with toes positioned over edge of step and equal WB
- therapist passively extends the patient’s first MTP
- positive = reproduction of symptoms
