NMS II OSCE II- problems if positive

Question 1

anterior innominate

Answer 1

unilateral forward displacement of ilium, sacrum or SI joint sprain
local pain over SI joint

Question 2

belt

Answer 2

pain in first part, no pain in second part- SI joint

pain in first and second part- lumbar involvement

Question 3

erichsen’s

Answer 3

pain in SI joint by stressing anterior SI joint ligament

Question 4

gaenslen’s

Answer 4

SI joint instability

SI joint pain on side being tested or radiating pain to thigh or groin

Question 5

goldthwait’s

Answer 5

pain before L5, S1 separation- SI joint problem

pain after L5, S1 separation- lumbar problem

Question 6

hibb’s

Answer 6

sacroiliac lesion (pain- positive)

Question 7

iliac compression

Answer 7

sprain of posterior SI ligament, SI joint inflammation or subluxation
pain is a positive finding

Question 8

lewin gaenslen

Answer 8

SI joint sprain or arthritis

SI joint pain on affected side or muscle tightness

Question 9

yeoman’s

Answer 9

SI joint lesion, specifically of anterior SI ligament
femoral nerve irritation
iliopsoas or rectus femoris muscle contracture
pain in SI joints and muscle tightness

Question 10

actual leg length

Answer 10

difference more than 6mm

hip joint to long bone deficiency

Question 11

apparent leg length

Answer 11

spinal or pelvic subluxation

difference more than 6mm

Question 12

allis sign

Answer 12

one knee is shorter compared to the other

looking for ipsilateral femoral leg descrapancy (protrusion acetabuli, hip dislocation, hip fracture)

Question 13

anvil

Answer 13

heel pain: calcaneous, tibia, fibula fracture

hip pain: arthritis, femoral neck fracture, infection

Question 14

gauvain’s

Answer 14

AVN, infection, fracture, gout
ipsilateral contraction of abdominal muscles
pain in hip
referred pain to groing or anterior thigh

Question 15

hip telescoping

Answer 15

hip dislocation or hip displasia

excess joint play or palpable click in joint

Question 16

patrick’s

Answer 16

DJD, OA, RA, SCFE, AVN, fracture, strain/sprain

pain in hip or patient is unable to perform the test

Question 17

ober’s

Answer 17

painful or may drop with clonus, indicates iliotibial contraction

Question 18

thomas

Answer 18

flexion contracture or shortening of iliopsoas on affected side
lumbar spine maintains lordosis or patient is unable to keep affected thigh flat on table

Question 19

trendelenburg

Answer 19

paralysis or weakness of hip abductors on affected side

high iliac crest on supported leg and low iliac crest on lifted leg

Question 20

ortolani

Answer 20

congenital femoral dislocation or instability in area

palpable click or “clunk”

Question 21

abduction (valgus) stress

Answer 21

MCL strain or rupture

pain or increased motion/gapping

Question 22

adduction (varus) stress

Answer 22

LCL strain or rupture

pain or increased motion/gapping

Question 23

apley’s compression

Answer 23

looking for meniscus tears
pain or crepitus with compression
internal rotation: lateral meniscus
external rotation: medial meniscus

Question 24

patella ballottement

Answer 24

retropatellar effusion or intraarticular knee swelling
patela is slow to return to resting position
there is increased patella movement
patella feels spongy

Question 25

bounce home test

Answer 25

meniscal tear

pain in joint or instability to fully extend knee

Question 26

clarke’s

Answer 26

chondromalacia patella or degeneration of patellofemoral joint
retropatellar pain

Question 27

mcmurray

Answer 27

lateral meniscus tear while internally rotating and valgus stress
medial meniscus tear while externally rotating and varus stress

Question 28

lateral pivot shift maneuver

Answer 28

ACL tear

patient feels like knee is joint to pop or give out

Question 29

lachman

Answer 29

sprain or rupture of ACL
pain with normal translation (grade I)
pain with increased translation (grade II or III)
pain with or without increased ACL translation

Question 30

drawer test

Answer 30

sprain or rupture of ACL and PCL
pain with normal translation (sprain)
pain with increased translation (rupture)
pain with or without increased ACL or PCL translation

Question 31

Q angle

Answer 31

less than 13 degrees suggests patellofemoral dysfucntion or patella alta
angle greater than 18 degrees suggests patellofemoral dysfucntion or patella valga