MSK special tests

Question 1

Neer’s impingement sign

Answer 1

press on scapula to prevent scapular motion with one hand, raise patient’s arm with the other
*pain indicates positive test & impingement of rotator cuff tendons

Question 2

Hawkin’s impingement sign

Answer 2

flex should & elbow to 90degrees w/ palm facing down & rotate arm internally
*pain indicates positive test & impingement of rotator cuff tendons

Question 3

Empty Can Test

Answer 3

have patient resist against downward pressure on arms

*weakness/pain indicates positive test & pathology of rotator cuff (supraspinatus)

Question 4

Infraspinatus & Teres Minor

Answer 4

flex elbows to 90 degrees in front of body w/ thumbs turned up
provide resistance as patient presses outward
*weakness/pain indicates positive test & pathology of rotator cuff

Question 5

Lift Off Test

Answer 5

place hand behind back w/ palm facing out

*limited movement/pain indicates positive test & pathology of rotator cuff (subscapularis)

Question 6

Drop-Arm Test

Answer 6

full abduct arm so it is straight up over head, have patient slowing lower it to their side
*at approx. 90 degrees, arm will suddenly drop if supraspinatus is torn

Question 7

Lateral Epicondylitis

Answer 7

apply resistance as patient extends & supinates wrist

*pain could indicate inflammation

Question 8

Medial Epicondylitis

Answer 8

apply resistance as patient flexes & pronates wrist

*pain could indicate inflammation

Question 9

What is the Finkelstein Test for?

Answer 9

DeQuervain’s Tenosynovitis

Question 10

Finkelstein Test

Answer 10

• place thumb in palm and cover w/ fingers, gently passively deviate the wrist towards the ulna
• extensor pollicis brevis, abductor pollicis longus
• pain could indicate inflammation

Question 11

What is the Tinel’s sign for?

Answer 11

Carpal Tunnel Syndrome

Question 12

Tinel’s Sign

Answer 12

lightly tap over median nerve on volar aspect of wrist

*positive test will produce aching/numbness in median nerve distribution

Question 13

What is Phalen’s sign for?

Answer 13

Carpal Tunnel Syndrome

Question 14

Phalen’s sign

Answer 14

patient presses dorsal aspects of both hands together to form right angles (compression median nerve)
*positive test will produce numbness/tingling in median nerve distribution within 60sec

Question 15

Spurling Test

Answer 15

passively laterally flex & extend ned with downward compression of head
*radicular sxs is positive sign & suggests cervical nerve impingement

Question 16

Cervical unload

Answer 16

with head in neutral/relaxed position, put one hand under occiput & one under chin & lift head
*positive test is reduction of sxs & suggests cervical nerve impingement

Question 17

Cervical load

Answer 17

with head in neutral/relaxed position, press on top of skull

*positive test is reproduction of sxs & suggests cervical nerve impingement

Question 18

FABER test

Answer 18

figure 4 position, press on knee & contralateral ASIS at same time
*pain indicates positive test

Question 19

Hoffman sign

Answer 19

flex middle nail of distal finger & look for index finger & thumb flexion
*positive test is considered pathological for upper motor neuron disease

Question 20

What are the 4 maneuvers for Waddell’s signs?

Answer 20

1. skin roll test
2. twist test-at hips
3. head compression test -5lbs
4. SLR-standing and seated should both elicit radicular pain

Question 21

Why would you test for Waddell’s signs?

Answer 21

malingering patient
secondary gain
worker’s compensation

Question 22

Bulge sign

Answer 22

• for minor effusions
• with knee extended, place left head above knee & apply pressure on supra patellar pouch & stroke downward
• fluid wave or bulge on medial side is positive bulge sign

Question 23

Balloon sign

Answer 23

• for major effusions
• place thumb & index finger of right hand on each side of the patella, w/ left hand, compress the supra patellar pouch against the femur
• will feel fluid with positive test

Question 24

Valgus Stress Test

Answer 24

• for MCL

- w/ patient supine & knee slightly flexed, push medially against the knee & pull laterally at the ankle

Question 25

Varus Stress Test

Answer 25

• for LCL

- w/ patient supine & knee slightly flexed, push laterally against the knee & pull medially at the ankle

Question 26

Anterior Drawer Sign

Answer 26

• for ACL
• w/ patient supine, hips flexed & knees flexed to 90 degrees, cup your hands around knee
• draw tibia forward & observe if it slides forward

Question 27

Posterior Drawer Sign

Answer 27

• for PCL
• w/ patient supine, hips flexed & knees flexed to 90 degrees, cup your hands around knee
• push tibia posteriorly & observe degree of backward movement

Question 28

Lachman Test

Answer 28

• for ACL
• place knee in 15 degrees flexion & external rotation
• grasp distal femur on lateral side w/ one hand & proximal tibia on medial side w/ the other
• with thumb of the tibial hand, pull tibia forward & femur back at the same time

Question 29

McMurray Test

Answer 29

• for meniscus tear
• w/ patient supine, grasp heel to flex knee & cup other hand over knee joint
• externally rotate foot while gradually extending knee to stress medial meniscus
• repeat with for internally rotated to stress lateral meniscus

Question 30

Thompson Test

Answer 30

• for Achilles tendon rupture
• have patient lay prone w/ both feet hanging off table
• squeeze calf of affected side
• positive test if foot remains neutral