MSK special tests Flashcards
Neer’s impingement sign
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
Hawkin’s impingement sign
flex should & elbow to 90degrees w/ palm facing down & rotate arm internally
*pain indicates positive test & impingement of rotator cuff tendons
Empty Can Test
have patient resist against downward pressure on arms
*weakness/pain indicates positive test & pathology of rotator cuff (supraspinatus)
Infraspinatus & Teres Minor
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
Lift Off Test
place hand behind back w/ palm facing out
*limited movement/pain indicates positive test & pathology of rotator cuff (subscapularis)
Drop-Arm Test
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
Lateral Epicondylitis
apply resistance as patient extends & supinates wrist
*pain could indicate inflammation
Medial Epicondylitis
apply resistance as patient flexes & pronates wrist
*pain could indicate inflammation
What is the Finkelstein Test for?
DeQuervain’s Tenosynovitis
Finkelstein Test
- 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
What is the Tinel’s sign for?
Carpal Tunnel Syndrome
Tinel’s Sign
lightly tap over median nerve on volar aspect of wrist
*positive test will produce aching/numbness in median nerve distribution
What is Phalen’s sign for?
Carpal Tunnel Syndrome
Phalen’s sign
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
Spurling Test
passively laterally flex & extend ned with downward compression of head
*radicular sxs is positive sign & suggests cervical nerve impingement
Cervical unload
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
Cervical load
with head in neutral/relaxed position, press on top of skull
*positive test is reproduction of sxs & suggests cervical nerve impingement
FABER test
figure 4 position, press on knee & contralateral ASIS at same time
*pain indicates positive test
Hoffman sign
flex middle nail of distal finger & look for index finger & thumb flexion
*positive test is considered pathological for upper motor neuron disease
What are the 4 maneuvers for Waddell’s signs?
- skin roll test
- twist test-at hips
- head compression test -5lbs
- SLR-standing and seated should both elicit radicular pain
Why would you test for Waddell’s signs?
malingering patient
secondary gain
worker’s compensation
Bulge sign
- 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
Balloon sign
- 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
Valgus Stress Test
- for MCL
- w/ patient supine & knee slightly flexed, push medially against the knee & pull laterally at the ankle
Varus Stress Test
- for LCL
- w/ patient supine & knee slightly flexed, push laterally against the knee & pull medially at the ankle
Anterior Drawer Sign
- 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
Posterior Drawer Sign
- 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
Lachman Test
- 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
McMurray Test
- 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
Thompson Test
- 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
