MSK Specialized Exams Flashcards
Lachman Test
Knee placed at 20 degree angle with pt in supine position & tibia is pulled forward to test laxity
Most sensitive for detecting ACL tears
Pivot Shift Test
Pt is supine starting with knee fully flexed, knee is then internally rotated (passively) and a valgus force is applied while the knee is slowly flexed.
ACL tear
Anterior Drawer Test
Knee placed at 90 degrees while pt is supine & tibial is pulled forward to test for laxity
ACL tear
Posterior Drawer Test
Pts knee is placed at 90 degree angle while pt is supine and tibia is pushed backward to test laxity
PCL tear
Posterior Sag Test
Patient’s hips flexed to 90 degrees while examiner support leg under lower calf & looks for posterior sag of the tibia
McMurray Test
With the patient supine the examiner holds the knee and palpates the joint line with one hand, thumb on one side and fingers on the other, whilst the other hand holds the sole of the foot and acts to support the limb and provide the required movement through range. From a position of maximal flexion, extend the knee with internal rotation (IR) of the tibia and a VARUS stress, then return to maximal flexion and extend the knee with external rotation (ER) of the tibia and a VALGUS stress.
- IR of the tibia + Varus stress = lateral meniscus
- ER of the tibia + Valgus stress = medial meniscus
- Positive findings: Pain, snapping, audible clicking or locking can indicate a compromised meniscus
Ober’s Test
Pain or resistance to adduction of the leg parallel to the table in a neutral position
indicative of iliotibial band syndrome or a tight tensor fasciae latae
Apley Test
evaluates for torn meniscus in patients who cannot stand/bear weight. While lying prone, place the pt’s knees into a flexed position at 90 degrees -→ rotate the tibia medially/laterally while applying pressure
positive test = clicking, pain, restriction.
Thessaly Test
evaluates for torn meniscus (most accurate) must be done 3 times.
pt stands flot footed on one leg with affected knee flexed to 20 degrees and then twists side to side
positive if locking/pain at medial or lateral joint lines
Varus Stress Test
LCL injury
apply a varus force (medial force)
positive if laxity or pain
Valgus Stress Test
MCL injury
apply a valgus force (lateral)
positive if increase in pain/laxity
Homan’s Sign
Deep vein thrombosis
passively perform dorsal and plantar flexion
positive if calf pain
Trendelenburg Test
Weakness of hip abductors on weight bearing leg
have pt stand on one leg and see if they can maintain a level pelvis
Thomas Test
restricted rectus femoris muscle (hip flexors)
lie on back and have them bring unaffected knee to chest
positive if affected leg will come off the table
Faber Test
evaluates for lower back vs hip injury
bring hip into flexion & abduct hip → if no pain then you can rule out hip as pain generator
CMC Grind Test
assess for arthritis of carpometacarpal joint
grip metacarpal bone of thumb & move in circle
positive = sharp pain
Drop Arm Test
rotator cuff injury
pain with inability to lift arm above shoulder level or hold it or when slowly lowering it
Empty Can Test
rotator cuff injury
arms elevated to 90 degrees with full internal rotation & pronation of forearm (thumb down pouring liquid out of can), examiner applies downward force while pt resistances
positive = pain, unilateral weakness
Neer Test
Shoulder impingement or Rotator cuff injury
arm fully pronated with thumb down and pt will then raise their arm (forward flexion)while shoulder is held down to prevent shrugging.
positive = pain
Hawkins Test
Rotator cuff injury or Shoulder Impingement
elbow & shoulder flexed to 90 degrees then examiner internally rotates arm
positive = pain
Apprehension Test
Anterior shoulder instability
patient is supine or standing and elbow move to 90 degrees and should abducted to 90 degrees
examiner applies external rotational force
positive = pt is apprehensive
Sulcus Test
inferior shoulder instability
with patient’s arm relaxed at side the examiner applies traction inferiorly
Elevated Arm Stress Test
Thoracic Outlet Syndrome
both shoulders should be abducted to at least 90 degrees -→ patient opens & closes fists for 3 minutes
positive = reproduction of symptoms
Finkelstein Test
De Quervain’s Tenosynovitis
first dorsal compartment pain with ulnar deviation while the thumb is flexed in the palm with thumb extension
