Musculoskeletal- Special Tests

Question 1

What does the Apprehension Test test for and how is it performed?

Answer 1

Anterior shoulder dislocation (pt is supine with the shoulder abducted to 90 degrees and elbow flexed to 90 degrees. therapist laterally rotates the shoulder. a look of apprehension from the patient before an end feel is reached, which may indicate anterior shoulder instability)

Question 2

What does Speed’s Test test for and how is it performed?

Answer 2

Biceps tendon pathology (pt is sitting or standing with the shoulder flexed to 90 degrees and forearm supinated. therapist resists active shoulder flexion while palpating the bicipital tendonitis. pain or tenderness in the bicipital groove may indicate bicipital tendonitis)

Question 3

What does Yergason’s Test test for and how is it performed?

Answer 3

Biceps tendon pathology (pt is sitting with the elbow flexed to 90 degrees and forearm pronated.. therapist resists active forearm supination and shoulder lateral rotation while palpating the bicipital groove. pain or tenderness in the bicipital groove may indicate bicipital tendonitis)

Question 4

What does the Drop Arm Test test for and how is it performed?

Answer 4

Rotator cuff tear (pt is sitting or standing with the shoulder abducted to 90 degrees. pt is asked to slowly lower their arm. presence of pain or inability to slowly lower the arm can indicate a rotator cuff tear)

Question 5

What does the Supraspinatus Test test for and how is it performed?

Answer 5

Supraspinatus tear, impingment, or suprascapular nerve involvement (pt is standing with the shoulder abducted to 90 degrees, then horizontally adducted 30 degrees, with the thumb pointing downward, therapists resists active shoulder abduction, weakness or pain may indicate a supraspinatus tear, impingement, or suprascapulat nerve involvement)

Question 6

What does the Adson Maneuver test for and how is it performed?

Answer 6

Thoracic outlet syndrome (pt is sitting or standing while the therapist monitors the radial pulse, the patient rotates their head toward the test side, then extends and laterally rotates the shoulder, an absent or diminished pulse may indicate thoracic outlet syndrome)

Question 7

What does Roo’s Test test for and how is it performed?

Answer 7

Thoracic outlet syndrome (ot is sitting or standing with both shoulders abducted and laterally rotated to 90 degrees and elbows flexed to 90 degrees. patient is asked to open and close their hands for 3 minutes. Weakness, sensory loss, ischemic pain, or an inability to hold the test position may indicate thoracic outlet syndrome)

Question 8

What does the Elbow Valgus Stress Test test for and how is it performed?

Answer 8

Medial collateral ligament sprain or instability (patient is sitting with the elbow flexed to 20-30 degrees. therapist applies a valgus force on the lateral side of the elbow while palpating the medial joint line. apprehension, pain, or increased laxity may indicate a medial collateral ligament sprain)

Question 9

What does the Elbow Varus Stress Test test for?

Answer 9

Lateral collateral ligament sprain or instability (pt is sitting with the elbow flexed to 20-30 degrees, therapist applies a varus force on the medial side of the elbow while palpating the lateral joint line. apprehension, pain, or increased laxity compared to the contralateral side, which may indicate a lateral collateral ligament sprain)

Question 10

What does the Lateral Epicondylitis Test test for and how is it performed?

Answer 10

Lateral epicondylitis (patient is sitting with the forearm pronated, therapist stabilizes the elbow with one hand and resists active extension of the third digit with the other hand just distal to the proximal interphalangeal joint. weakness or pain near the lateral epicondyle may indicate lateral epicondylitis)

Question 11

What does the Medial Epicondylitis Test test for and how is it performed?

Answer 11

Medial Epicondylitis (patient is sitting, therapist supinates the patient’s forearm, extends the wrist, and extends the elbow while palpating the medial epicondyle. pain near the medial epicondyle may indicate medial epicondylitis)

Question 12

What does Tinel’s Test test for and how is it performed?

Answer 12

Ulnar Nerve Compression (patient is sitting with the elbow slightly flexed, therapist taps between the olecranon process and medial epicondyle with their finger. tingling sensation in the ulnar nerve distribution may indicate ulnar nerve compression or compromise)

Question 13

What does the Capillary Refill Test test for and how is it performed?

Answer 13

Arterial Insufficiency (patient is sitting or standing, therapist compresses the nail bed, then releases and notes the amount of time it takes for the color to return. a delayed or muted response (greater than 2 seconds) may indicate arterial insufficiency)

Question 14

What does Phalen’s Test test for and how is it performed?

Answer 14

Carpal Tunnel Syndrome (patient is sitting or standing, patient presses the dorsal aspect of both hands against one other so that the wrists are maximally flexed and holds the position for 60 seconds. tingling in the thumb, index finger, middle finger, or lateral half of the ring finger may indicate carpal tunnel syndrome due to medial nerve compression)

Question 15

What does Tinel’s Sign test for and how is it performed?

Answer 15

Carpal Tunnel Syndrome (patient is sitting or standing, therapist taps the volar aspect of the wrist and their fingers. tingling in the thumb, index finger, middle finger, and lateral half of the wring finger may indicate carpal tunnel syndrome due to median nerve compression)

Question 16

What does Ely’s Test test for and how is it performed?

Answer 16

Rectus Femoris Contracture (patient is prone, therapist flexes the knee, hip flexion that occurs as the knee is flexed may indicate a rectus femoris contracture)

Question 17

What does Ober’s Test test for and how is it performed?

Answer 17

TFL Contracture (patient is sidelying with the hip and knee flexed, therapist moves the hip into extension and abduction, then slowly lowers it toward the table. inability of the leg to adduct and touch the table may indicate a tensor fasciae latae contracture)

Question 18

What does Craig’s Test test for and how is it performed?

Answer 18

Femoral Anteversion (patient is prone with the knee flexed to 90 degrees, therapist rotates the hip until the greater trochanter is parallel with the table, then the therapist measures the angle between the lower leg and the perpendicular axis of the table. an angle less than 8 degrees indicates femoral retroversion, while an angle greater than 15 degrees indicates excessive femoral anteversion)

Question 19

What does the Trendelenburg Test test and how is it performed?

Answer 19

Gluteus Medius Weakness (patient is standing, patient is asked to stand on one leg for ten seconds. a drop of the pelvis on the contralateral side may indicate gluteus medius weakness on the ipsilateral side)

Question 20

What does the Knee Anterior Drawer Test test for and how is it performed?

Answer 20

ACL injury (patient is supine with the hip flexed to 45 degrees and knee flexed to 90 degrees while the therapist sits on the patient’s forefoot, therapist pulls anteriorly on the proximal tibia with both hands while palpating the tibial plateau with the thumbs. excessive anterior translation of the tibia with a diminished or absent end feel may indicate an anterior cruciate ligament injury)

Question 21

What does the Lachman Test test for and how is it performed?

Answer 21

ACL Injury (patient is supine with the knee flexed to 20-30 degrees, therapist stabilizes the distal femur and applies an anterior force to the proximal tibia. excessive anterior translation of the tibia with a diminished or absent end-feel may indicate an anterior cruciate ligament injury)

Question 22

What does the Lateral Pivot Shift Test test for and how is it performed?

Answer 22

Anterolateral Rotary Instability (patient is supine with the hip flexed and abducted to 30 degrees and medially rotated slightly, therapist medially rotates the tibia and applies a valgus force to the knee while the knee is slowly flexed. a palpable shift or clunk between 20 and 40 degrees of flexion may indicate anterolateral rotary instability)

Question 23

What does the Knee Posterior Drawer Test test for and how is it performed?

Answer 23

PCL Injury (patient is supine with the hip flexed to 45 degrees and knee flexed to 90 degrees while the therapist sits on the patient’s forefoot, therapist pushes posteriorly on the proximal tibia with both hands while palpating the tibial plateau with the thumbs. excessive posterior translation of the tibia with a diminished or absent end feel may indicate a posterior cruciate ligament injury)

Question 24

What does the Knee Valgus Stress Test test for and how is it performed?

Answer 24

Medial Collateral Ligament Sprain (patient is supine with the knee flexed to 20-30 degrees, therapist applies a calgus force to the knee while stabilizing at the ankle with the other hand. excessive valgus movement may indicate a lateral collateral ligament sprain)

Question 25

What does the Knee Varus Stress Test test for and how is it performed?

Answer 25

Lateral Collateral Ligament Sprain (patient is supine with the knee flexed to 20-30 degrees, therapist applies a varus force to the knee while stabilizing at the ankle with the other hand. excessive varus movement may indicate a lateral collateral ligament sprain)

Question 26

What does Apley’s Compression Test test for and how is it performed?

Answer 26

Meniscal Lesion (patient is prone with the knee flexed to 90 degrees, therapist medially and laterally rotates the tibia at the heel while applying a compressive force through the tibia. pain or clicking may indicate a meniscal tear)

Question 27

What does the McMurray Test test for and how is it performed?

Answer 27

Posterior Meniscal Lesion (patient is supine with the knee in full flexion, therapist medially rotates the tibia at the distal leg, then brings the knee into full extension while palpating the joint line, repeat while rotating laterally. plain for a click/pronounced crepitation may indicate a meniscal lesion.)

Question 28

What does the Ankle Anterior Drawer Test test for and how is it performed?

Answer 28

Anterior talofibular ligament sprain (patient is supine with the ankle in 20 degrees of plantarflexion, therapist stabilizes the distal tibia/fibula while drawing the talus forward in the ankle mortise. excessive anterior translation of the talus may indicate an anterior talofibular ligament sprain)

Question 29

What does the Talar Tilt Test test for and how is it performed?

Answer 29

Calcaneofibular Ligament Sprain (patient is sidelying with the knee flexed to 90 degrees, therapist stabilizes the distal tibia/fibula while tilting the talus into abduction and adduction. Excessive adduction may indicate a calcaneofibular ligament sprain)

Question 30

What is Homan’s Sign and how is the test performed?

Answer 30

Deep Vein Thrombosis (patient is supine, therapist keeps the knee in extension while dorsiflexing the ankle. pain in the calf may indicate a DVT)

Question 31

What does the Thompson Test test for and how is it performed?

Answer 31

Ruptured Achilles Tendon (patient is prone with the feet over the edge of the table, therapist squeezes the muscle belly of the gastrocnemius/soleus muscles. absence of plantarflexion may indicate a ruptured achilles)

Question 32

How is the leg length discrepancy test performed?

Answer 32

patient is supine with the feet 15-20 centimeters apart, therapist measures with a tape measurer from the distal point of the anterior superior iliac spine to the distal point of the medial malleolus, a variation of greater than one centimeter between legs may indicate a true leg length discrepancy