Lower Extremity Special Tests

Question 1

Patrick (FABERE) test

Answer 1

Tests for osteoarthritis, Iliopsoas spasm and sacroiliac dysfunction

Flexion, abduction, external rotation, extension

Physician pushes on the joint and pain is a positive result

Question 2

FADIR test

Answer 2

Flexion abduction and internal rotation

Tests for (FAI) C-sign, possible labral tears and early OA.

Positive sign is pain

C-sign is patient cups ipsilateral hand on hip in a C shape

Question 3

Normal motion for hip flexion and extension

Answer 3

Flexion = 90-150 degrees

Extension = 0-35 degrees

Question 4

Normal motion for hip abduction and abduction

Answer 4

Abduction = 15-45 degrees

Abduction = 15-55 degrees

Question 5

Normal motion for hip external/internal rotation

Answer 5

External rotation = 10-55 degrees

Internal rotation = 20-50 degrees

Question 6

OBER test

Answer 6

Tests for tightness of iliotibial band or tensor fascia lata

Patient lateral recumbent position and knee is flexed with hip extended.

Positive sign is hip/knee remains abducted

Question 7

Trendelenburg test

Answer 7

Assess gluteus mediums on the leg standing side

Have patient stand on one leg and flex the other knee

Positive is non stance pelvis dips down.

Normal is non stance pelvis stays even with stance or even moves higher.

Question 8

Thomas test

Answer 8

Tests for contracture of Illiopsoas muscle of the non flexed leg.

Test is positive if the leg cannot lay on the table.

Indicates Iliopsoas hypertonicity

Question 9

MCL and LCL prevents what glide respectively

Answer 9

MCL= prevents excess vagus

LCL =. Prevents excess varus

Question 10

Knee joint normal motion

Answer 10

Flexion = 120-150 degrees

Extension = 2-10 degrees

Internal rotation = 10 degrees

External rotation = 30-40 degrees

Question 11

Bludgeon and ballottement test

Answer 11

Test for effusion of knee joint.

Question 12

Patellar grind test

Answer 12

Assess for patellofemoral syndrome and chondromalacia patellae

Can be active or passive

Positive test is pain.

Question 13

Q-angle

Answer 13

First line is drawn from ASIS to the center of the patella

Second line is drawn from center of patella through tibial tuberosity.

The angle formed between two lines are the Q-angle

women have larger Q-angles than men

Question 14

Apleys compression and distraction tests

Answer 14

Tests for torn meniscus (compression) and ligamentous disorder (distraction)

Positive = pain

Question 15

McMurray tests

Answer 15

Assess for medial and lateral meniscus tears

Positive = pop, click and pain

Question 16

O’donoghue Terrible or unhappy triad

Answer 16

ACL tear

Medial meniscal injury

MCL tear or injury

Question 17

Shelbourne and nitz patterns

Answer 17

ACL -> MCL -> lateral meniscus

Knee injuries tend to occur in the fashion.

Question 18

Anterior drawer test and Lachman test

Answer 18

Both test for ACL tears that are most common in pivot shift injuries

Drawer = bend knee to 90 degrees

Lachman = bend knee to 20-30 degrees

Both pull anteriorly on the proximal tibia

Positive is the tibia moves anteriorly.

Question 19

Posterior drawer and Godfrey’s test (posterior sag)

Answer 19

Tests for PCL tears

Drawer = knee flexed to 90 degrees and proximal tibia is pushed posteriorly.

Godfreys test = hip and knee flexed to 90 degrees and held by the physician

Positive for both = tibia falls Posteriorly

Question 20

Valgus and varus tests

Answer 20

Test MCL and LCL tears

Knee flexed to 15 degrees

Distal tibia is stabilized and medial/lateral forces are applied to the proximal tibia right below the femoral-tibial joint

Positive test = gapping and pain on the torn side.

Question 21

Normal ankle joint movement

Answer 21

Plantarflexion = 0-50 degrees

Dorsiflexion = 0-20 degrees

Foot supination/inversion = 0-35 degrees

Foot eversion/ pronation = 0-25 degrees

Question 22

Thompson test

Answer 22

Assess Achilles’ tendon tears

Pt prone and knee is flexed to 90 degrees

Squeeze calf muscle.

Positive = no plantar flexion upon squeezing

Question 23

Medial ankle joints

Answer 23

All have tibiotalar in name

Question 24

Lateral ankle joints

Answer 24

All have fibular and talofibular in their name.

Question 25

Deltoid ligament crosses what joints

Answer 25

Posterior tibiotalar

Tibiocalcaneal

Tibonavicular

Question 26

Anterior drawer test in ankle

Answer 26

Tests for anteriofibular ligament tear

Pt ankle in plantar flexion with cephalad hand stabilizing lower leg

Caudad hand applies posterior to anterior force from the calcaneus

Positive = 8mm translation of higher.

Question 27

Mortons neuroma

Answer 27

Most commonly seen between 3rd and 4th metatarsals

Irritation and inflammation via nerves in the narro toe box.

Most common in women wearing high heels.

Question 28

Mortons squeeze test

Answer 28

Tests for present of mortons neuroma

Pressure applied across metatarsals to impinge the neuroma

Positive = pain/numbness

Question 29

Hip joint vs shoulder joint

Answer 29

Hip is move stable but more restricted also

Question 30

Hip motions

Answer 30

Flexion: 120 degrees

Extension: 10 degrees

Hip abduction: 40 degrees

Hip adduction: 30 degrees

Internal rotation: 30 degrees

External rotation: 35 degrees