Lower Extremity Special Tests Flashcards
Patrick (FABERE) test
Tests for osteoarthritis, Iliopsoas spasm and sacroiliac dysfunction
Flexion, abduction, external rotation, extension
Physician pushes on the joint and pain is a positive result
FADIR test
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
Normal motion for hip flexion and extension
Flexion = 90-150 degrees
Extension = 0-35 degrees
Normal motion for hip abduction and abduction
Abduction = 15-45 degrees
Abduction = 15-55 degrees
Normal motion for hip external/internal rotation
External rotation = 10-55 degrees
Internal rotation = 20-50 degrees
OBER test
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
Trendelenburg test
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.
Thomas test
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
MCL and LCL prevents what glide respectively
MCL= prevents excess vagus
LCL =. Prevents excess varus
Knee joint normal motion
Flexion = 120-150 degrees
Extension = 2-10 degrees
Internal rotation = 10 degrees
External rotation = 30-40 degrees
Bludgeon and ballottement test
Test for effusion of knee joint.
Patellar grind test
Assess for patellofemoral syndrome and chondromalacia patellae
Can be active or passive
Positive test is pain.
Q-angle
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
Apleys compression and distraction tests
Tests for torn meniscus (compression) and ligamentous disorder (distraction)
Positive = pain
McMurray tests
Assess for medial and lateral meniscus tears
Positive = pop, click and pain
O’donoghue Terrible or unhappy triad
ACL tear
Medial meniscal injury
MCL tear or injury
Shelbourne and nitz patterns
ACL -> MCL -> lateral meniscus
Knee injuries tend to occur in the fashion.
Anterior drawer test and Lachman test
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.
Posterior drawer and Godfrey’s test (posterior sag)
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
Valgus and varus tests
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.
Normal ankle joint movement
Plantarflexion = 0-50 degrees
Dorsiflexion = 0-20 degrees
Foot supination/inversion = 0-35 degrees
Foot eversion/ pronation = 0-25 degrees
Thompson test
Assess Achilles’ tendon tears
Pt prone and knee is flexed to 90 degrees
Squeeze calf muscle.
Positive = no plantar flexion upon squeezing
Medial ankle joints
All have tibiotalar in name
Lateral ankle joints
All have fibular and talofibular in their name.
Deltoid ligament crosses what joints
Posterior tibiotalar
Tibiocalcaneal
Tibonavicular
Anterior drawer test in ankle
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.
Mortons neuroma
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.
Mortons squeeze test
Tests for present of mortons neuroma
Pressure applied across metatarsals to impinge the neuroma
Positive = pain/numbness
Hip joint vs shoulder joint
Hip is move stable but more restricted also
Hip motions
Flexion: 120 degrees
Extension: 10 degrees
Hip abduction: 40 degrees
Hip adduction: 30 degrees
Internal rotation: 30 degrees
External rotation: 35 degrees
