MSK Special Tests LE Flashcards
What is the Patrick’s FABER test?
identifies mobility restrition of hip
Patient supine, passive flec, ABD, ER leg so foot is resting just above opposite knee. Slowly lower testing leg down toward table
+ Involved knee unable to assume relaxed position and/or reproduction of pain
What is the Grind/Scouring test of the hip?
DJD of hip
Supine, hip at 90, knee maximally flexed, compressive load into femur via knee joint
+ Pain reproduced within hip joint and refer pain to knee or elsewhere
What is the Trendelenburg sign?
Weakness of gluteus medius, unstable hip
SLS, observe pelvis of stance leg
+ Ipsilateral pelvis drops when lower limb support is removed
What is the Thomas test?
Tightness of hip flexors
Patient supine with one hip and knee max flexed to chest and held there. Opposite limb is kept straight on table. Obs whether hip flexion occurs on straight leg as opposite limb is flexed.
+ Straight limb’s hip flexes and/or patient isunable to remain flat on table when opp limb flexed.
Does not differentiate between tight iliacus vs psoas major
What is the Ober’s test?
Tightness of TFL and/or ITB
Sidelying, lower limb flexed at hip and knee. Passively extend and abduct testing hip with knee flexed 90. Modified with knee extended. Slowly lower uppermost limb and obs if it reaches table
+ Positive if knee does not rest on table
What is Ely’s test?
tightness of rec fem
prone, knee of testing limb flexed. obs hip of testing limb
+ hip of testing limb flexes
What is the 90-90 HS test?
tightness of HS
supine, hip and knee of testing limb is supported in 90 flexion. Passively extend knee of testing limb until a barrier is encountered
+ knee unalbe to reach 10degress from neutral (lacking 10 extension)
What is the piriformis test?
identifies piriformis syndrome
Supine, foot of test leg passively placed lateral to opposite limbs knee. Testing hip is ADD. Obs position of testing knee relative to opposite knee
+ Testing knee is unable to pass over resting knee, and/or reproduction of pain in buttock, and/or along sciatic nerve distribution
How do you measure for leg length?
supine, pelvis balanced/aligned. Measure distance from ASIS to lateral malleolus or medial mall on each limb.
What is Craig’s test?
Abnormal femoral antetorsion angle
Prone, knee to 90degree flexion, palpate greater trochanter, slowly move hip thorugh IR/ER, stop when GT most lateral
Normal 8-15degree
15degree anteverted
What are the MCL and LCL tests?
ligament laxity or restriction of MCL and ACL
Supine, knee stabilized and placed into 20-30 flexion, valgus/varus force applied to knee
+ laxity, pain may be observed
What is Lachman’s stress tes?
integrity of ACL
Supine, testing knee flexed 20-30degrees. Stabilize femur and passively try to glide tibia anterior.
+excessive ant glide of tibia
What is pivot shift test?
ACL integrity
supine, testing knee in ext, hip flexed and ABD 30degree with slight IR. Hold knee with one hand and foot with other hand. Place valgus force through knee and flex knee.
+ lig laxity as indicated by tibia relocating during the test. As knee flexed, tibia clunks backward at approc 30-40degrees. The tibia at beginning of test was subluxed, then was reduced by pull of ITB as knee flexed.
What is the posterior sag test?
PCL integrity
Supine, testing hip flexed 45degrees and flexed 90. Obs to see whether tibia sags posteriorly in this position
+ sag of tibia
What is the posterior drawer test
PCL integrity
Supine, testing hip flexed 45 and knee flexed 90. Passively glide tibia posteriorly following the joint plane.
+ excessive posterior glide
What is the reverse Lachman’s test?
integrity of PCL
Prone, knees flexed to 30. Stabilize femur and passively try to glide tibia posterior.
+ lig laxity
What is the McMurray’s test?
identifies meniscal tears
Supine, knee in flexion
IR and and varus stress knee – lateral meniscus
ER and valgus knee – medial meniscus
+ reproduction of click and/or pain in knee joint
What is Apley’s test?
Differentiate between meniscal tears and ligamentous tears
Prone, knee flexed to 90degrees, distract then compress knee joint while turning IR/ER
+ Pain during distraction and compression = meniscal
Pain/decreased motion during distraction only = ligamentous
What is Hughston’s plica test?
dysfunction of plica
Supine, testing knee flexed with tibia IR. Passively glide patella medially, while palpating the medial femoral condyle. Feel for popping as you passively flex and extend knee.
+Pain and/or popping noted during test
What is the patellar apprehension test?
past Hx of patella dysfunction
Passively gliding patella laterally while patient is supine
+ patient does not allow
What is Clarke’s sign?
patellofemoral dysfunction
Supine, knee in extension, push on superior pole of patella, ask patient to contract quads
+ pain produced
What is the patellar tap test? (Ballotable patella)
infrapatellar effusion
Supine, knee in ext resting on table. Apply soft tap over the central patella.
+ perception of patella floating
What is the Fluctuation test of the knee?
joint effusion
Supine, knee in exs resting on table. Place one hand over suprapatellar pouch and other over anterior aspect of knee joint. Alternate pushing down with one hand at a time.
+ Fluctuation/movement of fluid noted
What is the Q angle? What is normal?
Measurement of angle between the quads and patellar tendon
Normal men 13degrees
Normal women 18degrees
What is the Noble compression test?
distal ITB friction syndrome present
Supine, hip flexed 45 and knee flexed 90. Apply pressure to lateral femoral epicondyle then extend knee
Pain reproduced over lateral femoral condyle. Usually around 30 flexion
What is the Tinel’s sign for the LE?
Dysfunction of common fibular nerve posterior to fibular head following common fibular nerve distribution
Tap region where common fibular nerve passes through post to fibula head
+ tingling and/or paresthesia into leg
What is neutral subtalar positioning?
abnormal rearfoot/forefoot positioning
Prone, foot over edge of table. Palpate dorsal aspect of talus on both sides with one hand, and grasp lateral forefoot with other hand. Gently DF foot until resistance is felt, then gently move foot through arc of supination/pronation
+Neutral position is point at which you feel foot fall off easier to one side or other. At this point, compare rearfoot to forefoot and rearfoot to leg
What is the Anterior drawer test?
ATFL instability
Supine, heel of table in 20 PF. Stabilize lower leg and grasp foot. Pull talus anterior.
+Talus has excessive anterior glide and/or pain
What is the Talar tilt test?
lif instability - particularly calcaneofibular lig
Sidelying, knee slightly flexed and ankle neutral. Move foot into adduction testing CFL and into abd testing deltoid lig.
+Excessive add or abd occurs, pain
What is the Thompson’s test?
Achilles tendon integrity
squeeze calf muscle
+no movement of foot while squeezing
What is the Tinel’s sign of the foot?
dysfunction of posterior tibial nerve posterior to medial mall or deep fib nerve ant to talocrural joint
supine, foot supported by table. tap over region of post tib nerve as it passes post to med mall. tap over region of deep fib nerve as it passes under dorsal retinaculum (ant to ankle joint)
+ tingling/paresthesia into nerve distributions
What is Morton’s test?
stress fracture or neuroma in forefoot
supine, foot supported on table. grasp around metetarsal heads and sqeeze
+ forefoot pain
