Musculoskeletal: Ankle and Foot: Special Tests Flashcards
Figure 8 Test
Why: To measure foot and ankle Edema
How: Measure a figure 8 pattern around the ankle and foot in cm.
Positive Test: One side is measured larger than the other indicating edema of the ankle.
Clunk Test
Why: To assess the integrity of the ankle mortise and tibia-fibula syndesmosis
How: Patient ankle is held off the end of the mat table and stabilized at the calcaneus. Therapist provides a laterally directed force to the foot.
Positive Test: Clunking sensation or lateral deviation of more than 3-5 cm.
Heel Thump
Why: To assess the ankle mortise and tibia-fibula syndesmosis and tibial stress fracture
How: Patient lies supine with ankle off end of mat table. Therapist applies a swift thump to the calcaneus
Positive Test: Pain in the Tibia
Posterior Drawer
Why: To assess for distal Tibial-fibular joint instability.
How: Patient is supine with ankle off mat table. Therapist stabilizes posterior ankle and applies a posterior directed force to the talus.
Positive Test: Excessive posterior translation of the talus in the ankle mortise
Squeeze Test
Why: To assess the tibial-fibular syndesmosis and for a high ankle sprain.
How: Patient is supine with knee flexed and foot on the table. Therapist applies compression to the tibia and fibula near the knee and then works toward the ankle.
Positive Test: Pain with compression of the Tibia and fibula.
Talar Tilt
Why: To assess the stability of the ATF, CF, PTF, and Deltoid ligament.
How: Patient lies on side. Therapist applies a downward force to the talus to stress the ligaments.
ATF: PF+IN
CF: Neutral+IN
PTF: DF+IN
Deltoid: Neutral+EV
Positive Test: Pain or excessive motion.
Anterior Drawer
Why: To test the stability of the ATF.
How: Patient is supine with ankle off edge of mat table. Therapist stabilizes the posterior ankle and then applies an anterior directed force to the talus.
Positive Test: Excessive anterior translation of the talus or pain in the ankle.
Kleiger Test
Why: To assess deltoid ligament.
How: Patient is seated. Therapist maximally dorsiflexes the ankle and then applies an external rotation force to the ankle.
Positive Test: Excessive motion at he medial ankle or pain at the medial ankle.
Navicular Drop Test
Why: To assess for over pronation of the foot and ankle/stability of the talus on the calcaneus.
How: Patient is sitting. Therapist measures from floor to navicular tubercle. Patient then bears weight through the ankle. Therapist measures from floor to navicular tubercle. Therapist compares the distance on the paper between the navicular tubercle in sitting and standing. The distance is recorded.
Positive Test: Distances of greater than 10mm displacement of the tubercle.
Windlass Test
Why: To assess the plantar fascia.
How: Patient bears weight through the foot. Pain is assessed. Therapist then extends the great toe while patient is standing. Pain is assessed.
Positive Test: Increased pain with great toe extension.
Thompson’s Test
Why: To assess for the integrity of the achilles tendon.
How: Patient is prone with ankle off table. Therapist squeezes plantar flexors.
Positive Test: Ankle fails to plantarflex.
Matle’s Sign
Why: To assess for the integrity of the achilles tendon.
How: Patient is prone. Knees are flexed to 90 degrees. Position of ankle is noted.
Positive Test: The involved ankle drops below the plane of the uninvolved ankle.
Homan’s Sign
Why: Presence of DVT
How: Patient is supine with ankle off of table. Therapist passively dorsiflexes the foot with knee extended.
Positive Test: Pain in the lower leg.
Tinel’s Sign
Why: To assess for tarsal tunnel syndrome.
How: Patient is supine. Therapist passively DF and EV the foot. Therapist then taps on nerves near the tarsal tunnel.
Positive Test: Numbness and tingling within the nerve distribution.
Buerger’s Test
Why: To assess lower extremity circulation
How: Patient is supine. Therapist flexes the hip and notes the color of the lower extremity. Therapist then has the patient move to the dependent position and notes the color of the lower extremity.
Positive Test: Patients leg becomes pale in the supine raised position and then has reactive hyperemia in the dependent position.
