Lower extremities: Orthopedic test findings

Question 0

Lateral stability test

Answer 0

plantar flex and invert

pain indicates sprained anterior talofibular ligament

Question 1

Drawer sign for ankle

Answer 1

laxity indicates probable loss of stability of anterior talofibular ligament

Question 2

medial stability test

Answer 2

evert patients foot while stabilizing tibia and calcaneus

palpable gap at ankle mortise indicates torn deltoid ligament

Question 3

Mortons test

Answer 3

intermetatarsal pain indicates mortons interdigital neuroma

Question 5

Strunskys test

Answer 5

rapid flexion of patients toes

pain indicates possible inflammatory reaction proximal to toes (commonly in metatarsal arch location)

Question 6

Apleys compression

Answer 6

patient prone, knee 90 degrees flexed
doctor compresses and rotates tibia on femur

pain indicates probable meniscal damage

Question 7

apleys distraction

Answer 7

patient prone, knee 90 degrees flexed
doctor distracts and rotates tibia on femur

pain indicates probable collateral ligament damage

Question 8

bounce home test

Answer 8

patient supine
knee slightly flexed and released

pain indicates probable torn meniscus, joint mouse, or intracapsular edema

Question 9

Mcmurray test

Answer 9

patient supine
doctor places valgus stress and external rotation to the knee while extending patients leg

pain and/or crepitation indicates probable meniscus tear and possible torn MCL

Question 10

Drawer test (knee)

Answer 10

patient supine
knee 90 degrees flexed
doctor draws tibia anteriorly then posteriorly

asymmetrical tibial draw on the femur indicates probable ACL damage
*more reliable than drawer test for ACL bc takes hamstrings out of the equation

Question 11

Patellar scrape test

Answer 11

patient supine
doctor compresses the patella what motioning the patella

pain and crepitation indicated probable retropatellar cartilage distortion (chondromalasia patella)

Question 12

PTT test

Answer 12

patient supine
knees extended and determine geometric center of patella and tibial tubercle
using a straight edge, determine the amount of tibial rotation

external tibial rotation of 5-8 degrees is normal. >8 degrees (1/4 in) is significant tibial torsion

Question 13

Adduction/Varus Stress test

Answer 13

patient supine
doctor exerts a medial to lateral stress to the knee

pain and excessive joint play laterally indicates LCL instability

Question 14

Abduction/valgus stress test

Answer 14

patient supine
doctor exerts lateral to medial stress to knee

pain and excessive joint play medially indicates probable MCL instability

Question 15

Fabre patrick test

Answer 15

patient supine
doctor applies femoral pressure into hip
patient crosses ankle over opp knee
doc applies slight pressure posteriorly on knee

pain indicates probable loss of hip biomechanics, inflammation, or arthritic hip alteration

Question 16

Hibbs test

Answer 16

patient prone
doc flexes knee (heel toward glutes) and abducts thigh and externally rotates hip

hip pain indicates probable loss of hip biomechanics

Question 17

Ober test

Answer 17

patient sidelying, legs extended, affected hip up
doc extends affected hip and slightly abducts affected leg
doc stabilizes pelvis with superior hand and grasps ankle with inferior hand
doc flexes knee to 90 degrees
thigh is abducted and extended

if leg remains abducted (and doesnt fall) then test is positive and indicates probable iliotibial band contracture

Question 18

Thomas test

Answer 18

patient supine
doc flexes unaffected leg and thigh looking for affected hip flexion

hip flexion deformity secondary to osteoarthritis, calve leg perthes, slipped epiphysis, bursitis, etc..

Question 19

Trendelenburg test

Answer 19

patient standing
doctor observe PSIS as patient raises one leg at a time parallel to floor

positive if PSIS doesnt rock P-I
indicates probable failure of extensor mechanics