MSK Special Tests UE

Question 1

What is Yergason’s test?

Answer 1

Integrity of transverse ligament of shoulder
Identifies bicipital tendonosis/tendonopathy

Elbow at 90, PT resists supination and ER of arm

+ when biceps pops out of groove, pain along bicep tendon

Question 2

What is the Speed’s test?

Answer 2

Bicipital tendonosis

PT resists patient shoulder flexion while arm supinated

+ when pain along biceps tendon

Question 3

What is Neer’s test?

Answer 3

Impingement of soft tissue structures (long head biceps, supraspinatus tendon)

SH passively abd and IR, shoulder flexion

+ reproduces pain/symptoms

Question 4

What is the supraspinatues test/empty can?

Answer 4

identifies tear and/or immpingement of supraspinatus tendon or suprascapular nerve neuropathy

PT resists SH flexion while patient in empty can position
Repeat in full can position

+ when reproduces pain

Question 5

What is the Hawkins Kennedy test?

Answer 5

Identifies AC joint issue

Elbow and shoulder at 90, PT passively turns SH into IR

+ with pain

Question 6

What is the drop arm test?

Answer 6

identifies tear and/or full rupture of RC

passively place SH in ABD to 120. ask patient to lower arm

+ unable ot lower arm back to side

Question 7

What is the posterior internal impingement test of the shoulder?

Answer 7

impingement betwee RC and greater tuberosity OR post glenoid and labrum

patient supine. Move SH into 90 ABD, max ER, and 15-20 horizontal ADD

+ pain in post SH

Question 8

What is the clunk test?

Answer 8

glenoid labrum tear

patient supine, SH in full ABD. push hueral head ant while rotating humerus externally.

+ audible clunk is heard

Question 9

what is the anterior apprehension sign?

Answer 9

identifies past Hx of ant SH dislocation

patient supine, shoulder in 90 ABD, slowly take SH into ER

+ patient doesn’t allow

Question 10

What is the posterior apprehension sign?

Answer 10

past Hx of post dislocation

patient supine, SH ABD 90 with scap stabilised by table. place post force through SH via force on patients elbow while simultaneously moving SH into medial rotation and horiz ADD

+ patient doesn’t allow

Question 11

What is the AC shear test?

Answer 11

dysfunction of AC joint (arthritis, separtation)

in sitting, arm resting at side. PT clasps hands and places heel of one hand on spine of scap, and heel of other on clavicle. Sweeze hands together to compress AC joint

+ reproduces pain

Question 12

What is Adson’s test?

Answer 12

Pathology of structures that pass through thoracic inlet / TOS

PT finds radial pulse, elbow extended and SH ER, slowly extend SH. Patient looks towards side being tested and extends neck.

+ pusle diminished

Question 13

What is the Costoclavicular syndrome test/ military brace?

Answer 13

thoracic inlet / TOS

Patient sitting, find radial pulse of extremity being tested. Move involved SH down and back, neck extends

+ pulse diminished, neuro symptoms

Question 14

What is the Wright/hyperabduction test?

Answer 14

thoracic inlet / TOS

passive SH ABD

+ neuro and vascular symptoms

Question 15

What is the Roos test?

Answer 15

thoracic inlet / TOS

SH fully ER, 90 ABD, elbows at 90. open/close hands for 3 min

+ neuro and vascular symptoms

Question 16

What is the ligament instability tests of the elbow (medial and lateral)?

Answer 16

Identifies medial/lateral ligament laxity of elbow

elbow placed in 20-0 flexion. valgus force tests ulnar collateral lig. varus force tests radial collateral lig.

+ laxity, maybe pain

Question 17

What is lateral epicondylisis / tennis elbow?

Answer 17

lateral epicondylopathy

elbow in 90 flex, pronated, hand in fist and supported. PT resists wrist extension

+ pain at lateral epicondyle

Question 18

What is medial epicondylisis / golfers elbow

Answer 18

medial epicondylopathy

90 elbow flexion, pronation, hand in fist. passive supinate and extend elbow and extend wrist.

+ pain at medial epicondyle

Question 19

What is Tinel’s sign?

Answer 19

dysfunction of ulnar nerve at olecranon

Tap region where ulnar nerve passes through cubital tunnel

+tingling in ulnar distribution

Question 20

What is the pronator teres syndrome test?

Answer 20

median nerve entrapment within pronator teres

elbow in 90 flexion and supported. resist forearm pronation and elbow extension

+ tingling or paresthesia in median nerve distribution

Question 21

What is the Finkelstein’s test?

Answer 21

De Quervain’s tenosynovitis

patient makes fist with thumb in fingers. passively move wrist into ulnar deviation

+ reproduces pain in wrist

Question 22

What is Bunnel Littler test?

Answer 22

tightness in structures surrounding MCP joints

MCP joint stabilised in slight ext while PIP flexed. Then MCP flexed and PIP flexed.

+ differentiates between tight capsule and tight intrinsic muscles. If flexion limited in both cases, capsule is tight. If more PIP flexion which MCP flexion, intrinsic muscles are tight.

Question 23

What is the tight retinacular test?

Answer 23

identifies tightness around proximal interphalangeal joint

PIP stabilised in neutral while DIP is flexed. Then PIP flexed and DIP flexed

+ differentiates tight capsule and tight reinacular ligs. If flexion limited in both cases, capsule tight. If DIP flexion with PIP flexion, then retinacular lig tight

Question 24

What are the ligament instabilit tests for the IP joints?

Answer 24

identifies lig lacity or restriction of med and lat IP joints

fingers supported. valgus and varus forces applied to PIP joint. Repeat on DIP

+ laxity, maybe pain

Question 25

What is Froment’s sign?

Answer 25

ulnar nerve dysfunction

patient grasps paper between thumb and index finger. pull paper out and look for IP flexion of thumb, which is compensation due to weakness of adductor pollicis

Question 26

What is Phalen’s test?

Answer 26

carpal tunnel compression of median nerve

maximally flex both writst holding thm against each other for 1 min

+ reproduces tingling/parasthesia in median nerve distribution

Question 27

what is Allen’s test?

Answer 27

vascular compromise

Have patient open/close fingers quickly several times and then make a closed fist. Using thumb, occlude the ulnar artery and have patient open hand. Observe palm of hand then release the compression on artery and observe for vascular filling. Repeat on radial artery.

Positive finding will present by abnormal filling of blood within hand during test. Under normal circumstances, there is a change in color from white to normal appearance on palm of hand.