Lower Extremity

Question 1

Straight Leg Raise (SLR)

Answer 1

Tests for impingement of spinal nerves/sciatic nerve

Elevate leg, dorsiflex foot

Pain into ipsilateral leg is a positive test -
suggests a lumbosacral radiculopathy

Pain in the contralateral leg is a positive crossed SLR

Tightness / discomfort in the buttocks or hamstring is not a positive test

Question 2

Seated Straight Leg Raise (SLR) “flip sign”

Answer 2

Patient seated with his/her hands on table

Extend leg

Watch for pt to “flip back” when leg extended

Question 3

FAbER Test

Answer 3

Supine “figure 4”

Assesses SI Joint Dysfunction

Assesses Adductors

• Flexion
• Abduction
• External Rotation

Question 4

Antalgic Gait

Answer 4

Limp adopted to avoid pain on weight-bearing structures, characterized by a very short stance phase

Patient remains on painful leg for as short a time as possible
“Limp” / Trendelenburg lurch

Question 5

Noble’s Test

Answer 5

IT Band Assessment

Patient is supine, palpate IT band and passively flex and extend the knee

Subjective test for pain

Question 6

Thomas Test

Answer 6

Iliopsoas (B)
- Positive is if femur raises off table

Or

Rectus Femoris (A)
 - Positive is unable to have 90 degree flexion of the knee

Question 7

Thomas Test

Answer 7

Iliopsoas (B)
- Positive is if femur raises off table

Or

Rectus Femoris (A)
 - Positive is unable to have 90 degree flexion of the knee

Question 8

Trendelenburg Sign

Answer 8

Identifies weak hip abductor muscles on side that is bearing weight (side we are testing)

If contralateral hip (not bearing weight) drops, the hip abductors on the weight bearing side are weak

Question 9

Clark’s Test

Answer 9

Prone position and assessment of the greater trochanter
Bring to neutral position and measure vertical to tibial shaft (8-15 degrees is acceptable)

Hip Antiversion “Pigeon-toed”

Hip Retroversion
“Duck foot”

Question 10

What are the Ottowa Knee Rules?

Answer 10

Age >= 55

Isolated tenderness at the patella (no other bony tenderness)

Tenderness at the fibular head

Unable to flex knee to 90

Able to bear weight immediately after and in ER for 4 steps (limping counts)

Any on of these positive with an appropriate MOI, the patient should get an xray (100% sensitive, 50% specific)

Question 11

Baker’s cyst (popliteal cyst)

Answer 11

A synovial fluid cyst located in the popliteal space

Palpable as fluctuant fullness

May be painful &/or, if they leak, result in calf swelling

Best to palpate with knee extended