MSK Tests

Question 1

Straight Leg

Answer 1

Perform: place patient in supine position, raise the patient’s relaxed and straightened leg, flexing the leg at the hip, then dorsiflex the foot

Diagnosis: nerve compression, sciatica, disc disorders,

Question 2

Valgus

Answer 2

Perform: patient supine, knees slightly flexed, move the thigh 30 degrees laterally to the side, place one hand against the lateral knee to stabilize femur and other hand around medial ankle, push medially on the knee and pull laterally at the ankle, **apply valgus stress (knock knee)

Diagnosis: medial collateral ligament injury

Question 3

Varus

Answer 3

Perform: place one hand against the medial surface of the knee and the other on the lateral ankle, push laterally against the knee and pull medially at the ankle, ** apply varus stress (bow legged)

Diagnosis: lateral collateral ligament

Question 4

Cross Arm

Answer 4

Perform: patient abducts arm across chest, palpate and compare bilateral shoulders for swelling and tenderness

Diagnosis: acromioclavicular arthritis

Question 5

Thompson

Answer 5

Perform: squeeze calf, foot doesn’t plantar flex, indicating positive test

Diagnosis: Achilles tendon rupture

Question 6

McMurray

Answer 6

Perform: patient supine, grasp the heel and flex the knee, cup hands around the knee and rotate the lower leg internally and externally, then apply valgus stress and rotate the leg externally and slowly extend it

Diagnosis: meniscus injury

Question 7

FABER/Patrick’s

Answer 7

Perform: hip Flexion, ABduction, Extension, Rotation (bring ankle to knee like figure four position)

Diagnosis: hip abnormality

internal rotation: posterior hip dislocation
external rotation: anterior hip dislocation
shortened extremity: femoral neck fracture

Question 8

Hawkin’s

Answer 8

Perform: elevate patient’s arm forward to 90 degrees while internally rotating the shoulder

Diagnosis: subacromial impingement or rotator cuff tendinitis

Question 9

OTTAWA

Answer 9

determines if patient needs ankle x rays

Question 10

Spurling

Answer 10

Perform: axial compression of the spine and rotation to the ipsilateral side of symptoms reproduces or worsens cervical radiculopathy, pain on side of rotation is positive test

Diagnosis: foraminal stenosis, nerve root irritation, cervical radiclopathy

Question 11

Ballottment

Answer 11

Perform: move patella to see if it is floating on fluid

Diagnosis: knee effusion

Question 12

Hoffman

Answer 12

Perform: tap the nail or flick the terminal phalanx of the middle or ring finger, a positive response is seen with flexion of the terminal phalanx of the thumb

Diagnosis: upper motor neuron myelopathy

Question 13

Anterior Drawer

Answer 13

Perform: patient supine, hips flexed and knees at 90 degrees with feet flat on table, wrap hands around knee with thumbs on patella, draw tibia forward and observe if it slides foward from under the femur

Diagnosis: anterior cruciate ligament tear

Question 14

Empty Can

Answer 14

Perform: elevate arms to 90 degrees, internally rotate so thumbs point down, apply downward pressure, weakness is positive

Diagnosis: rotator cuff or impingment

Question 15

Homan’s

Answer 15

Perform: dorsiflex foot

Diagnosis: DVT

Question 16

O’Brien’s

Answer 16

Perform: arm extended with thumbs rotated down, pain elicited with resisted motion

Diagnosis: labral tear

Question 17

Sitting Knee

Answer 17

Perform: patient sitting with both hips and knees flexed at 90 degrees, slowly extend knee, positive test with pain or if patient leans backwards

Diagnosis: disc herniation/degeneration, significant nerve root irritation

Question 18

Phalen

Answer 18

Perform: put back of hands together, hold for 60 sec, illicit pain

Diagnosis: carpal tunnel syndrome

Question 19

Sitting Knee

Answer 19

Perform:

Question 20

Drop Arm

Answer 20

Perform: fully abduct arm to shoulder and ask patient to lower slowly, tap their arm briskly, positive if they can’t hold the arm up

Diagnosis: rotator cuff tear

Question 21

Posterior Drawer

Answer 21

Perform: patient supine, hips flexed and knees at 90 degrees with feet flat on table, wrap hands around knee with thumbs on patella, push tibia back and observe degree of backward movement in femur

Diagnosis: posterior cruciate ligament tear

Question 22

Painful Arc

Neer’s

Answer 22

Perform: have patient fully pronate the arm and upwardly abduct, stabilize the scapula, pain during 70 & 120 degrees

Diagnosis: subacromial impingment

Question 23

Apprehension

Answer 23

Perform: patient supine or sitting, abduct shoulder to 90 degrees and elbow is bent, place one hand on shoulder and one on wrist, attempt to externally rotate the should, positive test is apprehensive and moves body with arm

Diagnosis: glenohumeral instability/dislocated shoulder

Question 24

Finklestein

Answer 24

Perform: make fist with thumb enclosed, flex the wrist, tenderness along the outer edge of the wrist

Diagnosis: De Quervans tenosynovitis

Question 25

Bulge

Answer 25

Perform: milk knee downward, apply medial pressure, tap and watch for fluid wave

Diagnosis: knee effusion

Question 26

Apley

Answer 26

Perform: ask patient to touch the opposite scapula with each arm, both over and under, “scratch test”

Diagnosis: adhesive capsulitis

*tests overall shoulder rotation

Question 27

Tinel

Answer 27

Perform: tap over medial nerve, produces tingling

Diagnosis: carpal tunnel syndrome